7 indicted in Houston case; charges represent just â€˜tip of the iceberg’
HOUSTON - Federal prosecutors have brought 101 counts of Medicare fraud and conspiracy against seven individuals in connection with the rampant explosion of power wheelchair claims in Harris County, Texas.
The indictment, which closely followed CMS Administrator Tom Scully’s 10-point plan to curb abuse in the power wheelchair market, is the first in what law enforcement expects to be an extensive fraud ring in the Houston area.
“The charges brought against these individuals were merely the tip of the iceberg,” said Nancy Herrera, executive assistant to the U.S. attorney. “The more we dig the more we find. “
Talk and activity from industry insiders indicate a similar feeling with a nation-wide industry clean-up campaign set to begin in Texas, where, in Harris County alone, claims for Medicare reimbursement for power wheelchairs leaped from 3,000 to 31,000 in just one year.
This jump may be explained by, what is being called, the “motorized wheelchair fraud scheme,” which alleges that some Houston-area DME companies are paying recruiters $200 to $800 per Medicare beneficiary they can secure a CMN for. The DMEs also are purportedly paying physicians $200 for each CMN they certify.
In addition, the physicians bill Medicare for the office visit and for any services they had deemed necessary.
“Our allegation is that the office visit was unnecessary and the treatment or services provided were unnecessary as well,” Herrera said.
One doctor allegedly billed Medicare for lumbar injections for many beneficiaries and another doctor, a psychiatrist, had patients sign a form saying they needed and received psychiatric care during the visit.
The former DME companies included in the indictment were Best Medical Equipment & Supplies, Medical Equipment and Supplies and Mescorp, whose owners, Ita John Obot, 46, and Aniefiok Jimmy Eking, 47, both are charged in the case.
Two of Eking’s employees, Lorine Hawthorne, 31, and Pamela Russell, 34, also are charged with conspiracy to commit healthcare fraud for their alleged role in recruiting Medicare beneficiaries.
Dr. Anant Mauskar, 71, owner of a medical practice in Houston, is charged for allegedly receiving kickbacks from Eking, fraudulently certifying a beneficiary’s qualifications for a power wheelchair and for billing for unnecessary tests. Mauskar’s office mangers, Nadine Norman, 43, also received conspiracy charges.
Finally, Dr. Lewis Gottlieb, 45, is charged by information in a similar, but unrelated case. Gottlieb allegedly billed Medicare for a total of $52 million and received a total of $16 million for services and equipment that was not medically necessary. Gottlieb allegedly received kickbacks from 1st Choice Medical Equipment and Supply, Thurman Family Medical Supply, Senior’s Comfort Care Medical Supply and Access Medical Supply, all of which have had their payments suspended or supplier numbers revoked.
“[These] charges represent the continuation of a deliberate process to ensure that our healthcare programs will be free from corruption,” U.S. Attorney Michael Shelby said during a press conference.
Each count of health care fraud carries a maximum penalty of 10 years in federal prison and a $250,000 fine. Conspiracy and illegal kickback convictions carry a 5-year sentence. The charges were a result of a joint investigation by the HHS, the FBI and the Medicaid Fraud Control office of the Texas Attorney General.