Five North Texans have been arrested, and two more indicted, for their alleged roles in Medicare fraud schemes that the U.S. Department of Justice says netted more than $700 million.
“This action represents the largest criminal health care fraud takedown in the history of the Department of Justice, and it adds to an already remarkable record of enforcement,” Attorney General Loretta Lynch said Thursday. “The defendants charged include doctors, patient recruiters, home health care providers, pharmacy owners and others. They billed for equipment that wasn’t provided, for care that wasn’t needed and for services that weren’t rendered.
Noble U. Ezukanma, 56, Myrna S. Parcon, 62, Lita S. Dejesus, 70, Oliva A. Padilla, 57, and Ben P. Gaines, 55, were arrested Tuesday for allegedly making more than $40 million by running false Medicare claims through three healthcare companies, US Physician Home Visits, Be Good Healthcare, Inc. and Essence Home Health.
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Investigators say the scam went like this: Ezukanma, a doctor, would visit a prospective patient in his or her home. According to the feds, the visits usually last 15 or 20 minutes. Ezukanma would bill Medicare for 90 minutes and the most comprehensive covered exam available. One of the front companies would then process the claim through Medicare, using Ezukanma's billing code. Moving forward, more than 90 percent of the patients Ezukanma saw were assigned in-home healthcare services that were never given. As a partial owner of USPHV, it was also illegal for Ezukanma to bill through the company, according to the Justice Department.
Each of the five arrested have been charged with conspiracy to commit healthcare fraud. They've all made bail, but face up to 10 years in prison and $250,000 fines. The Department of Justice's nationwide sweep netted charges against 243 people, including 46 doctors. It's the latest high-profile action in what's been a big first couple of months on the job for Lynch. In the last month, her agency's gone after FIFA, the biggest sports organization in the world, and the St. Louis Cardinals, one of the most popular teams in baseball.