FBI Arrests 91 People In $429 Million Medicare Fraud Scheme

Posted By Urban News Hour | October 4, 2012

A federal strike force has charged 91 people, including doctors and nurses, in seven cities with Medicare fraud schemes involving $429 million in false billings.

At a news conference, Attorney General Eric Holder says the case reveals an alarming trend of criminal attempts to steal billions of taxpayer dollars for personal gain. Holder called Thursday’s action against Medicare fraud one of the largest of its kind.

Health and Human Services Secretary Kathleen Sebelius says that that in addition to the newly announced charges, her agency used new authority under the federal health care law to stop future payments to many of the health care providers suspected of fraud.

The law enforcement effort targeted fraudulent Medicare schemes in Baton Rouge, La.; Brooklyn, N.Y.; Chicago; Dallas; Houston; Los Angeles and Miami.

Department of Justice spokeswoman Kathy Colvin said one Medicare provider in Arlington filed millions of dollars in fradulent claims since 2006. Dr. Joseph Megwa, 58, was charged with one count of conspiracy to commit health care fruad and three other counts of health care fruad.

In a release, Colvin said Megwa, who operated Raphem Medical Practice, used home health certifications to bill Medicare for services that weren’t medically necessary. He signed 33,000 prescriptions without reviewing them between 2006 and 2011, Colvin said.

He’s accused of billing $10 million to Medicare for “unnecessary home visits and unnecessary medical services.”

Registered nurses Ferguson Ikhile and Ebolose Eghobor were also charged. They worked at PTM Healthcare Services. About 25 percent of their patients used services provided by Megwa. An indictment says Megwa certified $4.8 million in claims from PTM.

In Grand Prairie, Dr. Nicolas Alfonso Padron, Lawrence St. John, 65, and his son Jeffrey St. John, 40, were charged with one count of conspiracy to commit health care fraud and 13 other counts of health care fraud. The elder St. John and his son owned A Medical, a business that offered home visits for Medicare beneficiaries.

Padron, the company’s medical director, gave his Medicare provider number to his colleagues so they could bill the service for care plan oversight, the indictment says.

Arlington residents Pamela Adenuga, 38, and her husband Kahinde Adenuga, 45, were charged with one count of conspiracy to commit health care fruad and seve other counts of health care fruad. They owned a durable medical equipment company and are accused of charging fake claims to Medicare since Nov. 2007.

Rowlett resident Olalekan Sorunke, 40, billed Medicare for unnecessary power wheelchairs and hospital beds that was “not medically necessary and, in some cases, was never provided to the Medicare beneficiaries,” Colvin wrote.

The owner of Lincoln Medical Supply, Inc., Sorunke was charged with four counts of health care fruad.

WFAA’s sister station KHOU reported six employees at a troubled Third Ward hospital in the south side of Houston were arrested.

Here’s their report:

The president of Riverside General Hospital, Ernest Gibson III and his son, Ernest Gibson IV, were among those taken into custody, according to the Houston Federal Bureau of Investigation.

All six suspects will appear in federal court at 2 p.m. The indictment against them will not be unsealed until that time, and the FBI declined to comment on the case any further.

The Houston Chronicle reported earlier this year that an executive at the cash-strapped hospital was arrested for his alleged role in a $116 million Medicare scheme, and FBI and state investigators seized thousands of patient records.



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