Home Health Agency Owner Pleads Guilty to Conspiring in $17 Million Medicaid Fraud Scheme

[nitpicker]

https://www.justice.gov/opa/pr/home-health-agency-owner-pleads-guilty-conspiring-17-million-medicaid-fraud-scheme

Department of Justice
Office of Public Affairs

FOR IMMEDIATE RELEASE
Thursday, March 30, 2017

Home Health Agency Owner Pleads Guilty to Conspiring in $17 Million Medicaid Fraud Scheme

Largest Provider Attendant Services Fraud in Texas History

The owner and operator of five Houston-area home health agencies pleaded guilty to conspiring to defraud Medicare and the State of Texas’s Medicaid-funded Home and Community-Based Service and Primary Home Care programs of more than $17 million. He also pleaded guilty to conspiring to launder money. These health care programs provided qualified individuals with in-home attendant and community-based services that are known commonly as “provider attendant services” (PAS). This case marks the largest PAS fraud case charged in Texas history. Godwin Oriakhi, 61, of Houston, pleaded guilty before U.S. District Judge Sim Lake of the Southern District of Texas to two counts of conspiracy to commit health care fraud and one count of money laundering. He is scheduled to be sentenced by Judge Lake on June 22, 2017.

According to his plea, Godwin Oriakhi admitted that he, his daughter and co-defendant Idia Oriakhi, and other members of his family owned and operated: Aabraham Blessings LLC, Baptist Home Care Providers Inc., Community Wide Home Health Inc., Four Seasons Home Healthcare Inc. and Kis Med Concepts Inc., all of which were home health agencies in the Houston area. Godwin Oriakhi admitted that he, along with his daughter and co-conspirators, obtained patients for his home health agencies by paying illegal kickback payments to patient recruiters and his office employees for hundreds of patient referrals. Oriakhi also admitted that he, along with his daughter and co-conspirators, paid Medicare and Medicaid patients by cash, check, Western Union and Moneygram for receiving services from his family’s home health agencies in exchange for the ability to use their Medicare and Medicaid numbers to bill the programs for home healthcare and PAS services. Oriakhi admitted that he, his daughter and their co-conspirators also directly paid some of these patients for recruiting and referring other Medicare and Medicaid patients to his agencies. Additionally, Oriakhi admitted that he, his daughter and other co-conspirators paid physicians illegal kickbacks payments, which Oriakhi and his co-conspirators called “copayments,” for referring and certifying Medicare and Medicaid patients for home health and PAS services.

Oriakhi further admitted that each time he submitted a claim predicated on an illegal kickback payment he knew he was submitting a fraudulent claim to Medicare or Medicaid based on his false representations that the claim and the underlying transaction complied with the federal Anti-Kickback Statute and other state and federal laws. Oriakhi further admitted that he knew that Medicare and Medicaid would not otherwise pay for the fraudulent claims, according to his plea.

In addition to the home healthcare and PAS services fraud scheme, Oriakhi admitted that he and his co-conspirators used the money fraudulently obtained from Medicare and Medicaid to pay illegal kickback payments to patient recruiters, employees, physicians and patients to promote the Medicare home health and Medicaid PAS fraud conspiracies, and ensure their successful continuation.

In total, Oriakhi admitted that he and his family submitted approximately $17,212,051 in fraudulent home healthcare and PAS claims to Medicare and Medicaid and received approximately $16,198,600 on those claims.
(snip)

[PoindexterOglethorpe]

1. What I hate most about these stories is that

they seem to be used to reduce Medicare and Medicaid.

It's also genuinely pathetic that people cheat the system like this.

[choie]

2. What pisses me off

is that the people who complain about Medicaid and Medicare fraud always seem to blame the recipients and not criminal providers like this company.