A Dallas area owner of a home health company has plead guilty to a healthcare fraud scheme that allegedly netted him roughly $43M according to the Department of Justice in a press release dated October 12, 2012. The scheme was directly related to the HEAT team takedown earlier this year of Dr. Jacques Roy, who was the center of the $374M fraud scheme. The press release from the US DOJ is after the jump.
Owner of Texas Home Health Services Company Pleads Guilty, Admits Role in $374 Million Fraud Scheme
WASHINGTON – A Dallas-area home health services company owner today admitted his role in a $374 million home health fraud scheme in which he and others conspired to bill Medicare for unnecessary services that were never performed. Cyprian Akamnonu, 64, of Arlington, Texas, entered his guilty plea to one count of conspiracy to commit health care fraud before U.S. District Judge Sam A. Lindsay in Dallas federal court.
The guilty plea was announced by Assistant Attorney General Lanny A. Breuer of the Justice Department’s Criminal Division; U.S. Attorney for the Northern District of Texas Sarah R. Saldaña; Special Agent in Charge Diego G. Rodriguez of the FBI’s Dallas Field Office; Special Agent in Charge Mike Fields of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Dallas Regional Office; and the Texas Attorney General’s Medicaid Fraud Control Unit (MFCU).
According to court documents, beginning in at least January 2006, Akamnonu, along with his wife Pat Akamnonu, owned and operated Ultimate Care Home Health Services, Inc. Cyprian Akamnonu admitted that he directed his wife and others to recruit Medicare beneficiaries from Dallas neighborhoods for home health services they did not need and for which they did not qualify. Once the beneficiaries were recruited, Cyprian Akamnonu would take prescriptions for home health services to the offices of Medistat Group Associates, P.A., owned and operated by co-defendant Jacques Roy, M.D.
Cyprian Akamnonu admitted he brought the prescriptions to Roy because he and Roy had a fraudulent arrangement whereby Ultimate provided Roy with beneficiaries to bolster Medistat’s patient roster in exchange for Roy’s certification for skilled nursing services of any beneficiary brought to him. Roy’s office manager, co-defendant Teri Sivils, and others would allegedly then sign these prescriptions on Roy’s behalf. Cyprian Akamnonu admitted to paying Sivils cash to sign the prescriptions.
Cyprian Akamnonu admitted that once he obtained signed prescriptions, nurses acting at his direction would perform cursory visits for the beneficiaries they had recruited that bore little relationship to the skilled nursing services which Roy had purportedly prescribed. Ultimate would then bill Medicare, at Cyprian Akamnonu’s direction, for skilled nursing services that were not necessary and were not performed.
Court documents show that from January 2006 through November 2011, Roy or another Medistat physician allegedly certified over 78% of the beneficiaries serviced by Ultimate. Ultimate billed over $43 million to the Medicare program for these beneficiaries. Roy, in turn, allegedly incorporated these beneficiaries into his own practice and billed over $2.4 million for services related to them.
At sentencing, Cyprian Akamnonu faces a maximum potential penalty of 10 years in prison and a $250,000 fine on the conspiracy count. Sentencing is currently scheduled for Feb. 4, 2013. As part of his plea agreement, he has also agreed not to contest the forfeiture of 21 real properties, four automobiles, and funds in a number of personal and business accounts connected to proceeds of the fraud.
His six co-defendants, including his wife, await trial on related charges, currently set for June 2013. The charges and allegations contained in the indictment against them are merely accusations and the defendants are presumed innocent unless and until proven guilty.
The case is being prosecuted by Assistant U.S. Attorneys Michael Elliott and Mindy Sauter of the U.S. Attorney’s Office for the Northern District of Texas, and Deputy Chief Sam Sheldon and Trial Attorney Ben O’Neil of the Criminal Division’s Fraud Section. The case was investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Northern District of Texas.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,480 defendants who have collectively billed the Medicare program for more than $4.8 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.