DOJ convicts healthcare provider in $20M Medicare fraud case

A registered nurse who owned two home health care agencies in Houston, Texas, was convicted in federal court Thursday for her role in defrauding Medicare of $20 million over an 8-year period, according to a press release from the Department of Justice on Thursday.

Evelyn Mokwauh, 52, of Pearland, Texas, who owned Beechwood Home Health and Criseven Health Management Corporation, was convicted after a four-day trial of one count of conspiracy to commit health care fraud and four counts of health care fraud. Sentencing is scheduled for Oct. 6.

Mokwauh’s co-defendant, Amara Oparanozie, 47, of Richmond, Texas, has already had her trial, pleaded guilty on May 24, and is awaiting sentencing.

Between January 2008 and February 2016, Mokwauh and Oparanozie, both registered nurses, reportedly made off with a total of $21.4 million by billing Medicare for fraudulent claims that were either not provided or were not medically necessary, including falsifying records to indicate patients were homebound when they were not, paying patient recruiters, and paying doctors to sign off on false healthcare plans so they could bill Medicare.

According to the official indictment, dated June 16, 2016, Mokwauh served as the director of nursing and administrator at both facilities she owned, while Oparanozie worked as a registered nurse at both facilities and as the office manager at Beechwood.

Amara Oparanozie

This wasn’t the first time Oparanozie had been in trouble during her career as a registered nurse. In June 2011, she and another caregiver were arrested in the death of a disabled man they had been caring for at an assisted living center in Richmond, Texas. Her co-worker was charged with injuring the disabled man, causing his death, while Oparanozie was charged with criminal negligence. Nonetheless, Oparanozie was still working as a registered nurse for both facilities owned by Mokwauh.

Mokwauh and Oparanozie were both arrested for their Medicare fraud scam as part of a larger takedown by the Justice Department in June 2016, when 301 healthcare professionals were arrested nationwide for stealing over $900 million. At the time, then-Attorney General Loretta Lynch called it the largest Medicare fraud takedown in history.

However, in July 2017, Attorney General Jeff Sessions bested the record, announcing the largest healthcare fraud takedown in the nation’s history, arresting 412 healthcare operatives nationwide, involving $1.3 billion total in fraudulent Medicare and Medicaid billings.

The complete report from the Justice Department is below:

Department of Justice
Office of Public Affairs

FOR IMMEDIATE RELEASE
Thursday, August 10, 2017

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

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.

 

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