On the Run

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55422471 - homecare nurse helping elderly lady to take her daily medicine.

There are some lists that most people would want to be on. For instance, the Top 10 wealthiest people in the world or the Dean’s list, if you are a university student. Then, there is a list or two that you would not want to be on. Today’s fraudster from Houston, Texas is on the U.S. Department of Health and Human Services’ Office of Inspector General’s Top 10 Most Wanted list for carrying out a $13 million Medicare fraud scheme. (He’s in a bit of trouble for being on the run after not showing up for his sentencing hearing.)

The man in today’s fraud case was declared a fugitive after he failed to show up for his sentencing hearing in October 2017. (His abrupt departure from the country had something to do with an impending eight-decade prison sentence.) The story goes that a pretrial services officer received an early morning tamper alert on the fraudster’s ankle monitor. After several calls that went unanswered, a warrant was issued for his arrest. (Apparently, his monitoring device was disengaged, and the Texan took a flight to Cameroon where he is purportedly hiding out.)

The $13 million Medicare fraud scheme was carried out with the help of his wife, who was the co-owner of a Houston-based home healthcare company. Over nine years, the deceptive couple paid illegal kickbacks to patient recruiters to refer Medicare beneficiaries to the home health services agency. The company also paid illegal kickbacks to Medicare beneficiaries and falsified medical records, so Medicare could be billed for home health services that were not medically necessary or never provided. (As a result of their fraudulent efforts, the couple received $13 million in Medicare payments.)

The wife was previously sentenced in 2017 to 75 years in prison, one of the longest-ever terms for healthcare fraud. Her husband’s 80-year sentence, which was issued in absentia, topped her prison sentence record though. He is now officially the holder of a record federal prison term for his participation in the fraudulent scheme. (Not exactly the kind of record you’d want to hold. Apparently, the lengthy sentence had something to do with the destruction of evidence, blackmail and perjury.)

A year prior to the 53-year-old husband’s sentencing, he pleaded guilty to one count of conspiracy to commit healthcare fraud, three counts of healthcare fraud, one count of conspiracy to pay and receive healthcare kickbacks, three counts of payment and receipt of healthcare kickbacks, and one count of conspiracy to launder monetary instruments. (And, as if that were not enough, he also pleaded guilty to filing false tax returns related to the home healthcare company.)

What is sad about this case (in addition to the fact that taxpayers and the government were scammed by this deceptive duo) is that the wife of today’s fraudster was terminally ill, suffering from stage IV metastatic breast cancer when sentenced. (She is also the mother of two young children who have been abandoned by their father).

Today’s “Fraud of the Day” is based on an article entitled, Texas Home Health Owners Make OIG’s Most Wanted List,” posted on HomeHealthcareNews.com on April 12, 2018.

The Office of Inspector General (OIG) has named a former owner of a Texas-based home health care company, Ebong Aloysius Tilong, among its “most wanted fugitives.”

Tilong was indicted on charges of conspiracy to commit health care fraud, health care fraud, conspiracy to pay kickbacks, payment of kickbacks and conspiracy to commit money laundering in November 2015. Tilong, along with his wife Marie Neba, fraudulently billed Medicare millions for home health care services that were either medically unnecessary or were not provided, investigators allege.

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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.