Brace Yourself

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close up of word medicare block letter

Most fraudsters are lazy, but opportunistic at the same time. You can be sure that they will do their best to make as much money as possible without much effort. The story behind a Wellington, Fl., internist turned fraudster doesn’t fit this typical description. He left poverty behind in Nigeria to immigrate to the U.S., where he put himself through medical school. (It’s such a shame that the man, who worked so hard to have a better life, made a very poor choice to commit Medicare fraud. Now, he has altered his life and his family forever.)

Dr. Joseph Agbi, 44, is just one of seven Palm Beach residents who were involved in defrauding Medicare out of $40 million. (Three co-conspirators were owners of medical supply stores and the other three were associated with companies who paid kickbacks to doctors.) Dr. Agbi was one of the doctors who accepted paybacks from medical supply and telemedicine companies for prescribing knee, back and shoulder braces that were not medically necessary.

The doctor was responsible for submitting $7.56 million in fraudulent billings. Out of that amount, he only pocketed $150,000 by ordering unnecessary medical devices for patients he never saw, nor examined. (That seems like such a small amount of money to trade for a lucrative and prestigious career as a doctor.)

Even though some of Dr. Agbi’s former and current colleagues wrote support letters requesting leniency for their friend, the judge sentenced the Illinois man to 18 months in prison for his involvement in the $40 million Medicare fraud scheme. He also lost his job at Wellington Regional Medical Center and was required to turn in his medical license. One positive to this unfortunate tale of fraud is that he is free until November 2, 2020, when he must report to federal prison to serve out his sentence. (Hopefully, the prison term will go by fast for his three daughters, who will have to go without a father for a year-and-a-half.)

Today’s Fraud of the Day comes from an article, “Wellington doctor sentenced for role in $40 million Medicare scheme,” published by The Palm Beach Post on February 3, 2020.

A Wellington internist has been sentenced to 18 months in prison for helping perpetuate a $40 million Medicare scam by signing orders for arm, knee and wrist braces that weren’t medically necessary.

Although federal prosecutors said Dr. John Agbi was responsible only for $7.6 million in fraudulent billings, he was ordered to help others involved in the scheme repay the entire $40 million that Medicare lost.

 

 

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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.