Sprung A Leak

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A taboo subject that most people don’t like to talk about is incontinence. The Urology Care Foundation reports that approximately a quarter to a third of men and women in the United States suffer from urinary incontinence. (No matter the cause, it can prevent lots of people from enjoying life.) Today’s fraudster – a man who is formerly from Atlanta, Georgia and Nigeria – took advantage of many clients who ordered incontinence products from his durable medical equipment company. He illegally collected more than half a million dollars before his Medicaid fraud scam sprung a leak.

 Estimates of annual costs for incontinence products average between $900 and $4,000 per year. (That’s a lot of money to pay out of pocket, unless you meet Medicaid eligibility requirements.) Currently, 45 states and the District of Columbia provide coverage for incontinence supplies such as bladder control pads and protective underwear. The owner of the medical equipment supply company engaged in a five-year Medicaid fraud scheme that involved over billing for incontinence supplies.

The company, which provided medical equipment supplies, incontinence supplies and garments to Washington, DC Medicaid recipients, was set up in the State of Maryland. He carried out his scam by instructing his staff to call Medicaid beneficiaries in the District of Columbia to identify their needs for incontinence supplies. (Then, he directed staff to complete prescriptions by ordering the maximum amount of incontinence supplies allowed by the DC Medicaid program, whether the beneficiary needed that amount or not.)

Once the CEO of the medical supply company determined the amount of incontinence supplies he needed to order to maximize his profits, he hired a billing company to submit claims to Medicaid for the maximum amount of supplies. (As a result of his deceptive deeds, he collected $580,000 in Medicaid funds he was not entitled to receive.)

The CEO, who operated his business out of Maryland and defrauded Medicaid beneficiaries in the District of Columbia, was arrested in Germany in December 2016. (That guy really got around.) He was extradited to the United States four months later where he faced charges related to his Medicaid fraud scheme.

The 41-year-old medical supply company owner pleaded guilty to Medicaid fraud and was sentenced to two years in prison for stealing more than half a million dollars. He was ordered to pay $552,343 in restitution to the District of Columbia Medicaid program in addition to forfeiting the same amount in cash. (During the investigation, he forfeited $28,600 in funds generated through the scheme.) After completing his prison term, he will also be required to serve three years of supervised release. (Let’s hope that the punishment for today’s diaper scam will require this criminal to cross his legs for a while and resist the urge to steal any more money from a government healthcare program.)

Today’s “Fraud of the Day” is based on a Department of Justice press release entitled, Owner of Durable Medical Equipment Company Sentenced to Two Years in Prison for Health Care Fraud,” released on December 13, 2017.

WASHINGTON – Emeka H. Chijioke, 41, formerly of Atlanta, Ga., and Nigeria, was sentenced today to two years in prison on a federal charge stemming from a scheme in which he defrauded the District of Columbia’s Medicaid program out of more than $500,000.

The announcement was made by U.S. Attorney Jessie K. Liu, Andrew W. Vale, Assistant Director in Charge of the FBI’s Washington Field Office, and Nicholas DiGiulio, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), for the region that includes Washington, D.C.

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Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.