Registered nurse pleads guilty in $5 million Medicare fraud scheme

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A multi-unit Medicare fraud investigation covering an eight-year period in Texas resulted in a guilty plea by a registered nurse who had bilked the system for more than $5 million.

Charles Esechie, 47, had worked for a home health care agency whose owner is awaiting trial and charged with numerous counts of health care fraud.  Esechie pled guilty on Friday to one count of conspiracy to commit health care fraud before U.S. District Judge Sim Lake of the Southern District of Texas. Sentencing is scheduled for August 17.

The case has been described as the largest PAS (provider attendant services) Medicare fraud case in Texas history.

In the plea agreement, Esechie admitted that between 2008 through 2015, he submitted fraudulent claims to Medicare for work he supposedly did for Baptist Home Care Providers, Inc., while he was in fact working his full time job for the Harris County Hospital District.

Baptist is one of five home health care agencies in the Houston area owned by Godwin Oriakhi, who is facing conspiracy, health care fraud, paying illegal kickbacks and money laundering at his April 11th trial. His daughter Idia Oriakhi (who was administrator of several of the health care agencies) and Jermaine Coleman, a patient recruiter, have already pled guilty and are awaiting sentencing.

“(Esechie) knew that Oriakhi obtained Medicare patients by paying illegal kickback payments to patient recruiters for referring patients to Baptist for home healthcare services that Esechie knew were medically unnecessary and often not provided,” the Department of Justice, Office of Public Affairs said in a press release. “Esechie also admitted that he knew that some of patients referred by the patient recruiters were homeless, and that many patients stayed at Baptist in order to receive kickbacks from Oriakhi rather than actual healthcare.”

In addition, Oriakhi and his office staff created templates for Esechie with the patient and medical information onto their (Baptist) Medicare documents so he could submit them while he was working at the hospital district. Esechie also admitted that he would over bill Medicare for comprehensive examinations while in reality, they lasted approximately five-to-10 minutes and were conducted in groups gathered at the home of a Baptist patient recruiter.

The Medicare Fraud Strike Force brought the case to the FBI, Department of Health and Human Services Office of the Inspector General’s (HHS-OIG), Internal Revenue Service Criminal Investigation’s (IRS-CI) and the Texas Attorney General’s Medicaid Fraud Control Unit (MFCU), who conducted the joint investigation and made yesterday’s announcement.

H/T: Department of Justice

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