Conviction in Medicare Fraud Scheme Involving Power Wheelchairs

As with many other forms of fraud, cases of health care fraud often involve a few primary wrongdoers who rely on the silence and/or complicity of many for their schemes to succeed. A federal jury in our own area was recently confronted with a case that follows this pattern and is a reminder of the fact that fraudulent actors rely on the willingness of people to cooperate with their schemes. Our San Francisco Medicare fraud lawyer is committed to the fight against Medicare fraud and to working with the brave individuals who speak up for what is right when they see companies and individuals engaged in this rampant crime.

Kickbacks, Solicitations, and Conspiracy to Commit Medicare Fraud healthcash.jpg
On December 4, the Justice Department announced that a federal jury in San Francisco had convicted Patrick Adebowale Sogbein, Adebola Adefunke Adebimpe (Sogebin’s wife), and Eduardo Abad on charges stemming from a Medicare fraud scheme. According to evidence presented at trial, Sogbein began working with a physician, Edna Calaustro, in December 2006 to obtain and file bogus prescriptions for power wheelchairs and related accessories. Initially, the scheme involved Debs Medical Distributors, a company owned by Sogbein. By 2008, Medicare began scrutinizing the claims more closely, leading Sogbein to partner with his wife and submit claims through Dignity Medical Supply, a Santa Clara-based company opened in Adebimpe’s name.

Along with Calaustro, the trio solicited Medicare beneficiaries in various San Francisco locations including a fast food restaurant and a senior center. After finding a cooperative beneficiary, one of the defendants would copy the person’s Medicare card and complete Medicare paperwork based on sham examinations. This would be supplemented by fraudulent paperwork from the medical equipment company and submitted to Medicare. Sogbein would pay his co-conspirators a set kickback fee for each beneficiary and each prescription. During the span of the scheme, the group submitted more than 400 bogus claims for power wheelchairs and totaled more than $3.2 million in fraudulent Medicare claims. Medicare paid Sogbein and Adebimpe over $1.6 million during the course of the fraud.

Calaustro and another defendant, Mele Saavedra, pled guilty to charges related to the fraud in the fall. Sentencing for Abad, Sogbein, and Adebimpe will occur in March.

The Danger of Health Care Fraud, The Importance of Whistleblowers
Commenting on the recent case and the government’s commitment to prosecuting Medicare fraud, United States District Attorney Melinda Haag noted, “Health Care Fraud is particularly pernicious because it not only defrauds the government but it inhibits Medicare’s ability to help those in need.” The Federal Bureau of Investigation webpage adds to Haag’s comments on the crimes, noting with particular concern the willingness of medical professionals to risk patient harm in order to further fraudulent schemes. Across the board, health care fraud costs the nation approximately $80 billion per year, a figure the FBI expects to only rise in coming years as health care spending continues to outpace inflation.

There were many people who could have alerted investigators to Sogbein’s crimes years earlier. There are many people who know about ongoing schemes, the majority of whom are likely struggling with what they should do. Remember that silence is a form of collusion and that good citizenship requires speaking up to protect the nation and the individuals harmed by fraud. As a California Medicare fraud law firm we can help you navigate the reporting process, protect you from possible retribution, and recover a whistleblower’s fee where appropriate. Call to discuss the law, the process, and your specific concerns.

See Related Blog Posts:
The Many Guises of Medicare Fraud: Part I

Addressing Medicare Fraud

(Photo by Flicker user 401(K) 2013)