Bad Business Decisions

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Bad business decisions can ruin a company. For instance, if your customers like the product or service you provide, don’t spend a lot of money trying to improve it. (Think of the New Coke vs. Old Coke saga back in the 1980s. If it ain’t broke, don’t fix it.) Another important decision to make is to hire the right people. If you hire the wrong people, they can destroy your entrepreneurial dreams of retiring early. A Fort Bend County, Texas registered nurse (R.N.), who owned two medical clinics, made a bad business decision to commit Medicare fraud. (He ran a lucrative fraud scheme that was part of the largest Medicare fraud takedown in history.)

Today’s fraudster is an R.N. who immigrated to the United States from Nigeria over 25 years ago. He owned and operated two clinics in the Houston, Texas area for nearly seven years. He acquired and maintained a Medicare provider number, which he used to submit home health care services claims that were not medically necessary and/or not provided.

The R.N. had several co-conspirators that helped him out. According to court documents, two physicians would falsely certify that the Medicare beneficiaries were under their care and home bound, when they were not. (He paid kickbacks to these doctors for their certification services, as well as to recruiters.)

The nurse signed medical records falsely certifying that the Medicare beneficiaries qualified for home health services and submitted the bogus claims to Medicare. The government health care company deposited payments into the bank accounts of his two companies. (Then, as you might guess, he spent the money – about $17,195,899.12 to be exact, but who is counting pennies?)

 The 48-year-old Texan pleaded guilty to committing Medicare fraud. Even though he expressed remorse for his actions and begged for mercy, the judge sentenced him to 10 years in federal prison to be followed by three years of supervised release. And get this, he must begin repaying the more than $17 million he stole in quarterly payments of $25. (Crickets chirping. Do the math and you can see that the government isn’t going to get much of that money back.)

This nurse’s Medicare fraud scam was part of the largest takedown of its type in history. More than 300 people from across the nation, including 22 in the Houston area, were charged with stealing more than $900 million from Medicare. The 301 individuals involved included 61 doctors, nurses and other professionals. It looks like all of them made some pretty bad business decisions. Their fate is now in the hands of the justice system, which as you know will most definitely punish them for their heinous crimes against the government, American taxpayers and the patients they victimized.

Today’s “Fraud of the Day” is based on an article entitled, Nurse sentenced to prison for $17.1 million in Medicare fraud,” posted on Chron.com on November 29, 2017.

Eric Ugorji, a registered nurse who relocated to the U.S. from Nigeria 25 years ago, made a lengthy statement to U.S. District Judge David Hittner expressing remorse for his actions and begging the court’s mercy.

“I was a good nurse and I made terrible, bad business mistakes,” said Ugorji, who is 48. “Your honor, I didn’t intend to defraud Medicare.”

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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.