WASHINGTON, Oct. 21 /PRNewswire-USNewswire/ -- Medicare fraud charges have been filed against six individuals in the continuing operation of the Medicare Fraud Strike Force in Houston, Assistant Attorney General Lanny A. Breuer of the Criminal Division, U.S. Attorney for the Southern District of Texas Tim Johnson and Daniel R. Levinson, Inspector General of the Department of Health & Human Services (HHS), announced today.
In an indictment unsealed today, Bassey Monday Idiong, 30, owner of B.I. Medical Supply LLC, Linda Eteimo Ere Kendabie, 27, an administrative assistant at B.I. Medical, and Modupe Babanumi, 42, a patient recruiter for B.I. Medical, all of whom reside in the Houston area, were each charged with participating in a scheme to submit claims to Medicare for medically unnecessary durable medical equipment (DME). In many instances, the DME was not given to the purported patients. This equipment included so-called "arthritis kits," which consist of sets of orthotic braces that are purportedly used for the treatment of arthritis-related conditions.
The indictment alleges that the defendants caused to be submitted to Medicare more than $840,000 in false and fraudulent claims for the kits at a billing cost of approximately $4,000 per kit. The indictment alleges that in one instance, B.I. Medical billed a kit to Medicare that included two knee braces for a Medicare beneficiary who had only one leg.
Charges were also unsealed yesterday against Ana Quinteros, 28, and Michelle Turner, 42, both of Houston, who were each charged in a superseding indictment with one count of conspiring to defraud Medicare for their participation in a scheme to submit false and fraudulent claims, also for arthritis kits. Four individuals charged in the original indictment of July 2009, Clifford Ubani, Princewill Njoku, Mary Ellis and Rolondae Mitchell-Straughter, were also charged with various healthcare frauds in the superseding indictment. The scheme resulted in approximately $1.1 million in billings to the Medicare program.
And, Charles L. Roberts, 57, of Houston, was arrested on Oct. 2, 2009, on a complaint in connection with his role as a recruiter for KO Medical, a DME company owned and operated by Kate and Oliver Nkuku. Charges against Kate and Oliver Nkuku were announced previously. The complaint charges Roberts, aka "Chucky Roberts," with conspiracy to commit health care fraud and alleges that he provided Medicare beneficiary information to KO Medical so false and fraudulent claims for power wheelchairs and other DME could be submitted to Medicare.
The complaint also alleges that KO Medical billed Medicare for power wheelchairs under special codes indicating that a new piece of DME was being provided as a replacement for a similar piece of DME that was lost, damaged or destroyed during a natural disaster, such as a hurricane. Use of this modifier when a bill is submitted to Medicare allows DME to be billed without a physician's prescription, because it is merely intended to replace a destroyed item that Medicare presumes was initially obtained with a proper prescription. The complaint alleges that in fact none of the beneficiaries involved actually had a power wheelchair that was lost or damaged. The complaint alleges that Oliver Nkuku paid Roberts a kickback of $400 each time Medicare paid for a power wheelchair for a beneficiary referred by Roberts.
The cases are being prosecuted by attorneys from the Criminal Division's Fraud Section, including Assistant Chief John S. (Jay) Darden, Trial Attorneys Charles Reed and Katherine Houston, and Special Trial Attorney Anthony Burba.
An indictment or a complaint is merely an allegation, and defendants are presumed innocent until and unless proven guilty.
The Strike Force in Houston is the fourth phase of a targeted criminal, civil and administrative effort against individuals and health care companies that fraudulently bill the Medicare program.
Since inception in March 2007, Strike Force operations in four districts have resulted in indictments of 331 individuals who collectively have falsely billed the Medicare program for more than $720 million. In addition, HHS' Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov
SOURCE U.S. Department of Justice