Insurance Fraud NEWS
Texas doc charged with selling signature for false scripts
June 19, 2018, Dallas, TX
Dr. Kelly Robinett's signature was worth a lot of money for one Dallas home health care company and its nurses, federal prosecutors say.
They allege that the Carrollton physician put it up for sale to make a $13 million home health care scam possible over an eight-year period. With that signature, Timely Home Health Services was free to recruit able-bodied people for home health care services they didn't need, prosecutors said Monday on the opening day of trial in Dallas.
Robinett, 69, never saw any of the patients he authorized home health care for, and he "didn't care to," said Assistant U.S. Attorney Aleza Remis.
"Dr. Robinett got paid to be a rubber stamp," Remis told jurors during opening statements.
Medicare paid the claims based on bogus "cookie-cutter" paperwork the defendants submitted, she said.
Remis said that the patients were vulnerable, elderly and "sometimes lonely" and that, while they enjoyed the visits, they were not confined to their homes as required to qualify for the health care services.
In the defendants' world, Remis said, "only one thing mattered: billing Medicare."
Nwanguma was a licensed vocational nurse working for Timely Home Health who falsified documents and accepted kickbacks for recruiting patients, prosecutors say.
Ogwuegbu used to be the company's director of nursing, according to the indictment.
Three others, including a second doctor and the co-owners of Timely Home Health, have pleaded guilty for their roles in the case and are scheduled to testify during the trial.
This week's trial, before U.S. District Judge Reed O'Connor, is the latest in a series of Medicare fraud prosecutions in North Texas involving home health care services.
The most notable case, involving former Rockwall physician Jacques Roy, wrapped up last August when a federal judge in Dallas sentenced him to 35 years in prison. Roy and his co-conspirators wooed about 11,000 Medicare patients with promises of cash, food stamps and groceries, prosecutors said.
They stole a record $373 million from Medicare and Medicaid with their home health care scheme using fake patients — including some of Dallas' homeless. At the time, it was the largest home health fraud ever orchestrated by a single doctor.
Timely Home Health Services, located on Forest Lane near LBJ Freeway, became a Medicare provider in 2004.
The alleged scheme ran from January 2007 to September 2015, the indictment says.
Robinett, a doctor of osteopathic medicine, owned Boomer House Calls in Frisco, the indictment says. His medical license, obtained in 1985, had been suspended in the early 1990s for prescription drug abuse after he wrote himself fraudulent prescriptions and showed up to work under the influence, state records say.
Doctors are supposed to refer their patients to home health care agencies, Remis said. But the owners of Timely Home Health, she said, did the opposite, referring patients to doctors such as Robinett and Dr. Angel Claudio, 61, of Mission.
Claudio pleaded guilty in May.
Robinett and Claudio certified the Medicare patients for home health care even though they weren't their doctors and the patients didn't qualify for the services, the indictment alleges.
Remis said Robinett earned $50,000 over three years just for signing documents.
One of the patients used in the billing scheme went shopping, cooked on her own and even went fishing, Remis said. She was visited at home by nurses weekly for seven years, which had no effect on her health situation, Remis said.
To thwart a Medicare review of the Timely Home Health's records, some of the defendants produced forgeries by cutting and pasting documents, Remis said. She said one employee kept a box of "cut-up documents" under her desk "because she knew this day would come."
Attorneys for Robinett and Ogwuegbu declined to make an opening statement Monday.
Nicole Knox, an attorney for Nwanguma, told jurors that her client was born in Nigeria and came to the U.S. more than 20 years ago, eventually becoming a U.S. citizen.
She said he works 60 hours a week as a home health nurse and never earned more than $21,000 a year for the work. Knox said Nwanguma was told what to do and when while he worked for Timely Home Health. She called him a "low man on the totem pole."
"Why is he here?" she asked jurors.
Knox said that her client's nursing notes were "always made in good faith" and that none of his patients complained about him. On the contrary, many loved him, she said.
Nwanguma did not determine their needs, Knox said. He only visited them and provided care authorized by his employer, she said. He never believed he was committing fraud, nor should he have, Knox added.
Two others, Patience Okoroji and Usani Ewah, co-owned Timely Home Health Services and recruited patients for the scheme, authorities said.
Ewah, the company's director of nursing and a registered nurse, pleaded guilty earlier this month.
And Okoroji, an administrator and licensed vocational nurse, pleaded guilty last week.
Okoroji and Ewah paid people, including Nwanguma, to recruit Medicare beneficiaries for home health services, prosecutors said.
Some of those Medicare patients are scheduled to testify on behalf of the government this week.
But one of the patients included in the indictment died in January 2016. Prosecutors said that they learned about this only while preparing for trial but that the patient's son would testify about her condition during the alleged conspiracy.
A sixth defendant, physician's assistant Shawn Chamberlain of Collin County, was charged separately and pleaded guilty in 2016.
Chamberlain, part-owner of Boomer House Calls, hired Robinett to apply for a Medicare number so he could use it to sign false physician certifications indicating that people needed home health care, court records allege.
Chamberlain provided the certifications to Timely Home Health from August 2013 to September 2015, resulting in about $1.6 million worth of false Medicare billings, according to his indictment.
Source: The Dallas News