Registered Nurse Convicted in $20 Million Medicare Fraud Scheme

The defendant engaged in a scheme to defraud Medicare for health services that were not provided or medically necessary

Registered Nurse Convicted in $20 Million Medicare Fraud Scheme
Image: Pixabay
August 11, 2017

A federal jury has convicted a registered nurse who was the owner of two home health companies in Houston, Texas for her role in a $20 million Medicare fraud scheme involving fraudulent claims for home health services, the U.S. Department of Justice (USDOJ) announced.

Evelyn Mokwuah, of Pearland, Texas, was convicted of one count of conspiracy to commit health care fraud and four counts of health care fraud for her conduct at Beechwood Home Health and Criseven Health Management Corporation.

$20 million in fraudulent claims

According to evidence presented at trial, from 2008 to 2016 Mokwuah and others engaged in a scheme to defraud Medicare of approximately $20 million in fraudulent claims for home health services at Beechwood and Criseven that were not provided or not medically necessary.

According to the trial evidence, Mokwuah:

  • Billed for patients who were not homebound or did not qualify for home health services;
  • Falsified patient records to show patients were homebound when they were not;
  • Paid patient recruiters to recruit Medicare beneficiaries to Beechwood and Criseven; and
  • Paid doctors to sign off on falsified plans of care for the recruited beneficiaries so that Beechwood and Criseven could bill Medicare for those services.

Sentencing

Sentencing for Mokwuah has been scheduled for October 6, 2017 before U.S. District Judge Gray H. Miller of the Southern District of Texas.

The co-defendant in the case, Amara Oparanozie of Richmond, Texas, pleaded guilty on May 24, 2017 to conspiring with Mokwuah and others to commit health care fraud and is awaiting sentencing.

This case was investigated by the Federal Bureau of Investigation (FBI) and the Office of Inspector General of the U.S. Department of Health & Human Services (HHS-OIG), and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division's Fraud Section and the U.S. Attorney's Office for the Southern District of Texas.

Since its inception in March 2007, the Medicare Fraud Strike Force has charged over 3,500 defendants who collectively have falsely billed the Medicare program for over $12.5 billion.