The DOJ Continues to Root Out Healthcare Fraud

aidan-bartos-313782-copy-300x200On August 10, the Department of Justice (DOJ) announced victory in another healthcare fraud case. A federal jury convicted registered nurse, Evelyn Mokwuah, 52, of criminal involvement in a $20-million Medicare fraud scheme. Mokwuah owned two home health companies based out of Houston, Beechwood Home Health and Criseven Health Management Corporation. She and these companies were convicted of making fraudulent claims to Medicare for home health services.

Healthcare Fraud Trial Ends Well for Government

There was a four-day trial regarding Mokwuah’s fraudulent activities. She was convicted of four counts of health care fraud and one count of conspiracy to commit health care fraud. Evidence at trial was based on claims made to Medicare by the two companies between 2008 and 2016. Fraudulent claims were made for home health services that were either not provided or were provided when not medically necessary.

Mokwuah would bill Medicare for patients who were not homebound or did not qualify for home health services. She and other workers falsified patient records to indicate they were homebound when they actually were not. Additionally, Mokwuah paid patient recruiters to specifically recruit Medicare beneficiaries to Beechwood and Criseven. She also paid doctors to sign off on false care plans for the recruited beneficiaries, enabling the two companies to bill Medicare.

Mokwuah will scheduled to be sentenced on October 6. Her co-conspirator and co-defendant, Amara Oparanozie, 47, pleaded guilty on May 24 and is also awaiting sentencing.

How the Case Came About

Many healthcare fraud cases arise through qui tam actions. Within a qui tam claim, a private citizen comes forward with information and files suit under the False Claims Act against the defendant on behalf of the government. The government is then notified, has time to investigate, and can join the suit or not. Qui tam suits lead to billions of dollars in recovery for the federal and state governments.

However, not all healthcare fraud cases arise through qui tam suits. In the case above, Mokwuah and Oparanozie were investigated by the Federal Bureau of Investigation and the U.S. Department of Health and Human Services-Office of Inspector General. The case was brought as part of the Medicare Fraud Strike Force, which is a joint organization initiative. Since the Strike Force was formed in March 2007, it has brought cases against thousands of defendants and recovered more than $2 billion.

Do You Have Information About Healthcare Fraud?

If you work in any type of medical company that you believe is intentionally incorrectly billing a state or federal health program to increase their reimbursements, contact an experienced California qui tam attorney at Brod Law Firm right away. The private information you have many be all that is necessary to uncover fraud against the government and lead to a multi-million dollar recovery for Medicare, Medicaid, or a state-based health program like Medi-Cal.

To learn more about your rights and options as a potential whistleblower, call (800) 427-7020 to schedule a free consultation.

(image courtesy of Aidan Bartos)