Registered Nurse Who Owned Two Houston Home Health Companies Convicted in $20 Million Medicare Fraud Scheme

Thursday, August 10, 2017

A federal jury today convicted a registered nurse who was the owner of two home health companies in Houston for her role in a $20 million Medicare fraud scheme involving fraudulent claims for home health services.

Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division, Acting U.S. Attorney Abe Martinez of the Southern District of Texas, Special Agent in Charge Perrye K. Turner of the FBI’s Houston Field Office and Special Agent in Charge C.J. Porter of the U.S. Department of Health and Human Services-Office of Inspector General’s (HHS-OIG) Dallas Region made the announcement.

After a four-day trial, Evelyn Mokwuah, 52, of Pearland, Texas, was convicted of one count of conspiracy to commit health care fraud and four counts of health care fraud for her conduct at Beechwood Home Health (Beechwood) and Criseven Health Management Corporation (Criseven).  Sentencing has been scheduled for October 6, before U.S. District Judge Gray H. Miller of the Southern District of Texas, who presided over the trial.

According to evidence presented at trial, from 2008 to 2016, Mokwuah and others engaged in a scheme to defraud Medicare of approximately $20 million in fraudulent claims for home health services at Beechwood and Criseven that were not provided or not medically necessary.  According to the trial evidence, Mokwuah billed for patients who were not homebound or did not qualify for home health services; Mokwuah and others falsified patient records to show patients were homebound when they were not; Mokwuah paid patient recruiters to recruit Medicare beneficiaries to Beechwood and Criseven; and Mokwuah paid doctors to sign off on falsified plans of care for the recruited beneficiaries so that Beechwood and Criseven could bill Medicare for those services.

Co-defendant Amara Oparanozie, 47, of Richmond, Texas, pleaded guilty on May 24, to conspiring with Mokwuah and others to commit health care fraud and is awaiting sentencing.

The case was investigated by the FBI and HHS-OIG, and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Texas.  The case is being prosecuted by Trial Attorneys Scott Armstrong and Kevin Lowell of the Criminal Division’s Fraud Section.

The Fraud Section leads the Medicare Fraud Strike Force, which is part of a joint initiative between the department and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. The Medicare Fraud Strike Force operates in nine locations nationwide. Since its inception in March 2007, the Medicare Fraud Strike Force has charged over 3,500 defendants who collectively have falsely billed the Medicare program for over $12.5 billion.

Woman Pleads Guilty to Medicaid Fraud and Identity Theft Charges

Wednesday, August 9, 2017

A Richmond woman pleaded guilty today healthcare fraud and aggravated identity theft.

According to court documents, Chermeca Harris, 36, was a Medicaid beneficiary and would misrepresent her health condition to health care providers, such as hospitals and ambulance services, in order to obtain health care benefits. Specifically, Harris would falsely represent that she was suffering from sickle cell anemia and was having a sickle cell crisis in order to obtain pain killing drugs, such as dilaudid, which she wanted to receive intravenously through the neck. In fact, doctors tested Harris in January 2016, and determined she did not have sickle cell anemia. The hospitals involved were Virginia Commonwealth University Medical Center, Chippenham, Bon Secours St. Mary’s, Memorial Regional, John Randolph Medical Center, and Henrico Doctor’s. According to court documents, it was a further part of the scheme that Harris also falsely represented her identity. On some occasions she used the name of M.M., and on other occasions she used the name of R.J.; both Medicaid recipients. She also falsely stated to investigating federal agents that her name was M.M. and that she had sickle cell anemia.

Harris was charged as part of the largest ever health care fraud enforcement action by the Medicare Fraud Strike Force, involving 412 charged defendants across 41 federal districts, including 115 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $1.3 billion in false billings. Of those charged, over 120 defendants, including doctors, were charged for their roles in prescribing and distributing opioids and other dangerous narcotics. Thirty state Medicaid Fraud Control Units also participated in today’s arrests. In addition, HHS has initiated suspension actions against 295 providers, including doctors, nurses and pharmacists.

Harris pleaded guilty to healthcare fraud on the Medicaid program and aggravated identity theft. She faces a mandatory minimum of two years in prison and a maximum penalty of 12 years in prison, when sentenced on October 26. Actual sentences for federal crimes are typically less than the maximum penalties. A federal district court judge will determine any sentence after taking into account the U.S. Sentencing Guidelines and other statutory factors.

Dana J. Boente, U.S. Attorney for the Eastern District of Virginia; Adam S. Lee, Special Agent in Charge of the FBI’s Richmond Field Office; and Nick DiGiulio, Special Agent in Charge, Philadelphia Regional Office of Inspector General of Department of Health and Human Services, made the announcement after the plea was accepted by Magistrate Judge David J. Novak. Assistant U.S. Attorney David T. Maguire is prosecuting the case.

A copy of this press release is located on the website of the U.S. Attorney’s Office for the Eastern District of Virginia. Related court documents and information is located on the website of the District Court for the Eastern District of Virginia or on PACER by searching for Case No. 3:17-cr-77.

Richmond Man Sentenced to 33 Months for Embezzlement

July 31, 2017

LEXINGTON, Ky. – A Richmond, Ky., man, who previously admitted to embezzling money from several related commercial real estate companies in Lexington, has been sentenced to 33 months in federal prison.

Today, U.S. District Court Judge Joseph M. Hood sentenced 65-year-old Robert K. Chaffins for four counts of mail fraud. Chaffins was Vice President of the Asset Management Division of a conglomerate of related entities, namely Lex/108, LLC, Leestown Distribution, LLC, Melbourne Distribution Center, LLC, and 801 Realty, LLC. In this role, Chaffins was responsible for collecting various payments from tenants renting business space from these entities. Knowing some of the fees provided for in the leases were not being collected, he set up bank accounts in the name of these entities, billed the tenants for particular fees through the U.S. Mail, and deposited payments into the bank accounts for his personal use.

In total, from February of 2007 until January 28, 2016, Chaffins deposited $1,064,522.36 in checks intended for Lex/108, LLC, Leestown Distribution, LLC, Melbourne Distribution Center, LLC, and 801 Realty, LLC, into bank accounts he controlled. He used this money to make payments on a second home, a Mercedes Benz, investment and retirement accounts, and dozens of other personal expenses.

Chaffins pleaded guilty to the mail fraud charges in March 2017. Under federal law, he must serve 85% of his prison sentence and will be under the supervision of the United States Probation Office for three years following his term of incarceration.

Carlton S. Shier, IV, Acting United States Attorney for the Eastern District of Kentucky; Jon Oldham, Resident Agent in Charge, United States Secret Service, Lexington Resident Office; and Chief Mark Barnard, Lexington Police Department, jointly announced the sentence.

The United States Secret Service and the Lexington Police Department conducted the investigation and Assistant United States Attorney Kathryn Anderson represented the United States.