Federal Jury Convicts Doctor of $40 Million Medicare Fraud
In another case of a federal jury conviction of medicare fraud, the home health care sector provided ample opportunity to defraud the federal government out of $40 million and after expenses towards investigation, $4 million is ordered in restitution, nearly $2 million in fines and jail time.
Following a five-day trial before U.S. District Judge Jane Boyle, a federal jury has convicted Noble U. Ezukanma, 57, of Fort Worth, Texas, of seven counts of medicare fraud offenses, announced U.S. Attorney John Parker of the Northern District of Texas Friday, March 24, 2017.
Ezukanma was convicted of one count of conspiracy to commit medicare fraud and six counts ofmedicare fraud. The health care fraud conspiracy count carries a maximum statutory penalty of 10 years in federal prison and a $250,000 fine. Each health care fraud count also carries a maximum statutory penalty of 10 years in federal prison and a $250,000 fine. Ezukanma was taken into custody following the verdict. A sentencing date will be set at a later date.
Co-defendants Myrna S. Parcon, a/k/a “Merna Parcon,” 62, of Dallas, Texas, Oliva A. Padilla, 57, of Garland, Texas, Ben P. Gaines, 55, of Plano, Texas, and Ransome N. Etindi, 57, of Waxahacie, Texas have pleaded guilty to their role in the scheme and are awaiting sentencing. Lita S. Dejesus, 70, of Allen, Texas, also pleaded guilty and was sentenced to 24 months in federal prison and ordered to pay $4,193,655.78 in restitution.
Ezukanma, Parcon, and Dejesus owned/operated US Physician Home Visits (USPHV), a/k/a “Healthcare Liaison Professionals, Inc.” located on Viceroy Drive in Dallas. Parcon was the owner/manager and Ezukanma was a licensed medical doctor who had an ownership interest in USPHV. Both Ezukanma and Etindi provided their Medicare number to the company to use to submit Medicare claims. Dejesus served in various roles at USPHV, including overseeing Medicare billing.
Gaines formed A Good Homehealth (A Good), a/k/a “Be Good Healthcare, Inc.,” which was located in the same office as USPHV. Parcon, who owned and operated A Good, purchased the company through a “straw” buyer; both Gaines and Parcon concealed Parcon’s ownership.
Parcon and Padilla formed Essence Home Health (Essence), a/k/a “Primary Angel, Inc.,” located on Midway Road in Addison, Texas.
While the three companies appeared to be set up as three separate entities, the companies worked as one; the same employees often worked for all three companies and were often paid by all three companies.
According to evidence presented at trial, from January 1, 2009 to approximately June 9, 2013, Ezukanma and Etindi certified 94% of the Medicare beneficiaries receiving home health services from A Good, and 65% of the Medicare beneficiaries receiving home health services from Essence. Had Medicare known of the true ownership and improper relationship between the three companies, Medicare would not have allowed these companies to enroll in the program and bill for services.
USPHV submitted billing primarily under Dr. Ezukanma’s Medicare provider number, regardless of who actually performed the service. They billed at an alarming rate, generally billing for only the most comprehensive physician exam, and always adding a prolonged service code. USPHV submitted claims to Medicare for physician visits of 90 minutes or more, when most visits took only 15 to 20 minutes. Most all of USPHV patients came from home health companies soliciting certifications and recertifications for home health. More than 97% of USPHV Medicare patients received home health care, whether they needed it or not. The false certifications caused Medicare to pay more than $40 million for fraudulent home health services.
The case was investigated by the U.S. Department of Health and Human Services – Office of Inspector General, the FBI, the and the Texas Attorney General’s Medicaid Fraud Control Unit and were brought as part of the Medicare Fraud Strike.
Assistant U.S. Attorneys Katherine Pfeifle and Douglas Brasher prosecuted on the medicare fraud case.
For the original press release for this story, go to: Department of Justice
|Written by Susen Sawatzki
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