A federal jury convicted Texas doctor Noble U. Ezukanma, 57, of Fort Worth, of conspiracy and multiple counts of health care fraud, the Department of Justice announced. The single conspiracy count and six counts of healthcare fraud each carry a maximum 10-year prison sentence and $250,000 fine.
Ezukanma was taken into custody after the decision was handed down and will be sentenced at a later date. Five other defendants have pleaded guilty to roles in the scheme. Four are awaiting sentencing and a fifth will serve two years in prison and pay more than four million dollars in restitution, the DOJ said.
Ezukanma and two other defendants owned and operated US Physician Home Visits in Dallas. Ezukanma had an ownership interest in the company. Along with co-defendant Ransome Etindi, they allowed their Medicare number to be used to submit Medicare claims.
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Two other healthcare companies were formed by the defendants, known as A Good Homehealth and Essence Home Health. The three companies appeared to have been set up as separate companies, they in fact worked as one.
According to the DOJ, evidence showed that from January 1, 2009 to roughly June 9, 2013, Ezukanma and Etindi certified 94% of the Medicare beneficiaries receiving home health services from A Good Homehealth, and 65% of the Medicare beneficiaries receiving 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," the DOJ said.
US Physician Home Visits submitted most billing under Dr. Ezukanma's Medicare provider number, and billed at an "alarming rate," generally billing for only the most comprehensive physician exam, and adding a prolonged service code. And even though most visits took only 15 to 20 minutes, the company submitted claims to Medicare for visits of 90 minutes or more. More than 97% of their Medicare patients received home health care, even if it wasn't medically necessary, and the false certifications spawned more than $40 million in false Medicare claims.