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Latest Legal News from the Criminal Courts in Houston, Texas
June 20, 2007
RECRUITER IN MOTORIZED WHEELCHAIR FRAUD SCHEME SENTENCED TO PRISON
(HOUSTON, TX) - David Dennis Brown has been sentenced to 80 months in federal prison for his role as a recruiter in a far-reaching scheme to defraud Medicare of millions of dollars, United States Attorney Donald J. DeGabrielle, Jr. announced today.
At a hearing this morning, Judge Vanessa Gilmore sentenced Brown 48, formerly of Winnfield, Louisiana, and a current resident of Webster, Texas, to a five-year prison term – the statutory maximum sentence – for conspiring to violate the laws of the United States, and 80-month imprisonment for his health care fraud and wire fraud convictions. The sentences are to be served concurrently. Brown was also sentenced to three years supervised release upon the completion of his prison term and was found to be liable for restitution to Medicare in the amount of $2,188,200.
Brown is one of several defendants convicted by a federal jury in Houston in October 2006, including Charles Frank Skripka, Jr., M.D., 65, Jayshree Patel, M.D., 62, and Pius James Ekiko, 43, of health care fraud for their roles in a fraudulent scheme which involved several tiers of illegal conduct -- (1) the payment of kickbacks by Durable Medical Equipment (DME) companies to recruiters who solicited Medicare beneficiaries to be evaluated by complicit doctors; (2) the referral and transport of beneficiaries by the recruiters to those physicians to secure a false or fraudulent Certificate of Medical Necessity (CMN) required to bill Medicare for a motorized wheelchair; and (3) the use of the fraudulent CMNs by DME company owners to bill Medicare for the medically unnecessary wheelchairs, and the delivery of a scooter instead to the beneficiary.
Doctors Skripka and Patel had been hired solely to authorize motorized wheelchairs for Medicare beneficiaries who clearly did not meet the Medicare guidelines to receive such a device, and routinely approved wheelchairs for as many as 30 to 80 patients a day without performing a physical examination or ordering any medical tests. The beneficiaries were falsely certified for an expensive motorized wheelchair and subsequently provided with a far less expensive scooter.
Recruiters such as Brown recruited Medicare beneficiaries with the promise of free scooters and the payment of $50 to see Doctors Patel and Skripka. Brown recruited over 500 patients from Louisiana and transported them 350 miles to Houston to see the physicians.
DME companies, such as Pius Ekiko’s business, Horizon Medical Supply, then paid the doctor’s office $200 per fraudulent prescription and CMN, and also paid recruiters such a Brown as much as $1,000 per patient in order to be able to supply the equipment to the beneficiary and thus be able to bill Medicare for that particular beneficiary. Suppliers such as Ekiko would then use the fraudulent prescription and CMN to bill Medicare for a motorized wheelchair, but would instead deliver a significantly less expensive item known as a scooter to the beneficiary. Medicare paid suppliers approximately $4,200 per wheelchair, while the scooters that were actually provided were only paid at a rate of $1600 per scooter.
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