Too Good to be True

17

There are some criminals who are on a mission to defraud from the get-go, then there are others who find themselves stuck in a difficult position where they want to do the honorable thing, but in the end choose not to for whatever reason. (It’s hard to guess what the motives of any given fraudster might be for committing a crime, but in the end it all comes down to knowing right from wrong.) A Nigerian doctor, who was on a mission to improve the quality of life for the elderly, disabled and those unable to afford healthcare, probably made a difference in many lives, but at the expense of the Medicaid healthcare program.

The Nigerian doctor ran multiple clinics throughout two Michigan towns. Further research revealed that he previously operated four clinics, a home visiting service and provided a variety of services to senior housing residents. Many of his patients had health insurance such as Medicaid and Medicare. For those who had no medical coverage, he was known to charge fees on a sliding scale and even gave free care to those patients without medical coverage.

In addition to being a physician, the man was also a pharmacist. He wrote prescriptions and also provided free prescriptions, compliments of drug manufacturers. Apparently, he also provided an exercise class at one senior location, bought lunch for residents, set up a recreational room at one location and bought a television for another. He also gave out scholarships to high school and college students, plus cash awards to younger students who made good grades. (I bet all of that generosity led to a steady client base boosted by word-of-mouth advertising. He almost sounds too good to be true.)

The 57-year-old physician pleaded guilty to three counts related to Medicaid billing fraud. Each charge is punishable by up to four years and/or $50,000. He will have to pay restitution of $407,3401.12 and give up his Drug Enforcement Agency number when sentenced. He was deemed a flight risk and was required to turn in his passport as a condition of his $10,000 bond.

The physician didn’t flee the country, but moved south to Georgia where he is reportedly practicing medicine. (Perhaps his ability to be a provider in the Medicaid program should have also been revoked.) In the beginning, this doctor most likely intended to help his patients, but along the way became greedy. His practice turned out to be too good to be true and he ended up harming those he intended to help.

Source: Today’s ”Fraud of the Day” is based on an article entitled, ”Saginaw-area doctor pleads guilty to felonies for Medicaid fraud,” posted on mlive.com on October 27, 2016.

SAGINAW, MI — A Nigerian doctor who lived in Saginaw Township and ran clinics throughout Saginaw and Flint pleaded guilty for defrauding a taxpayer-funded health care program.

Dr. Chidozie Ononuju, 57, pleaded guilty on Oct. 27, to three counts of medical fraud-false claim after making fraudulent Medicaid billings, according to a press release from Michigan Attorney General Bill Schuette.

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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.