MEC&F Expert Engineers : The California Division of Workers’ Compensation (DWC) has suspended nine more medical providers from participating in California’s workers’ compensation system due to fraud or other criminal actions

Friday, November 24, 2017

The California Division of Workers’ Compensation (DWC) has suspended nine more medical providers from participating in California’s workers’ compensation system due to fraud or other criminal actions



California's DWC Suspends Nine Medical Providers for Fraud
The Division of Workers’ Compensation (DWC) has suspended nine more medical providers from participating in California’s workers’ compensation system, bringing the total number of providers suspended this year to 94. The providers were suspended for fraud or other criminal actions.

DWC Administrative Director George Parisotto issued suspension orders against the following providers:

·       Sathish Narayanappa Babu of Bolingbrook, Illinois, physician, was convicted on federal charges of Medicare fraud and of fraudulently obtaining controlled substances in February 2015. The Medical Board of California has revoked his medical license.
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Uche Chukwudi of Gardena, physician, was indicted in 2013 in federal court on felony conspiracy and health care fraud charges for defrauding Medicare in a scheme involving durable medical equipment (DME) provider Adeline Ekwebelem, Uche Chukwudi, Charles Okoye and others. He failed to appear at pre-trial proceedings and was declared a fugitive. The Medical Board of California revoked his license in 2017.

·       Charles Ikechukwu Okoye of Carson, physician, was convicted in federal court for conspiracy to commit health care fraud for defrauding Medicare in a scheme involving DME provider Adeline Ekwebelem, Uche Chukwudi and others in 2014. Okoye surrendered his physician’s and surgeon’s certificate in 2015.
 
·       Adeline Ekwebelem of Gardena, DME provider who worked with Uche Chukwudi, Charles Okoye and others, was convicted in federal court on multiple counts of health care fraud, conspiracy and illegal kickbacks for patient referrals in 2014.

·       Victoria Kim of Los Angeles, physician, pled guilty in federal court on a felony charge of receiving illegal kickbacks for home health care referrals. The Medical Board of California revoked her medical license in 2016.
·       Daria Renee Million of Corona, registered nurse, pled guilty in Riverside County in May 2015 to DUI and in December 2015 to misdemeanor child endangerment. The California Board of Registered Nursing revoked her license in 2016. 
·        
The following providers participated in an illegal kickback scheme to issue medically-unnecessary DME prescriptions to Medicare patients:

o   Victoria Onyeabor of Ontario, DME provider and former owner of Fendih Medical Supplies Inc., was convicted in federal court for conspiracy to commit health care fraud in 2012 for submitting false and fraudulent claims to Medicare. 
o   Godwin Onyeabor of Ontario, DME provider and corporate officer of Fendih Medical Supplies Inc., was convicted in federal court in 2013 for conspiracy to commit health care fraud, health care fraud, and conspiracy to pay and receive health care kickbacks. 
o   Sri Jayantha Wijegunaratne of Anaheim Hills, physician, was convicted in federal court in 2013 for conspiracy to commit health care fraud, health care fraud, and conspiracy to pay and receive health care kickbacks. His medical license was revoked in 2016.


AB 1244, which went into effect January 1, requires DWC’s Administrative Director to suspend any medical provider, physician or practitioner from participating in the workers’ compensation system in cases in which one or more of the following is true:

  • The provider has been convicted of a felony or misdemeanor involving fraud or abuse of the Medi-Cal or Medicare programs or the workers’ compensation system, fraud or abuse of a patient, or related types of misconduct;
  • The provider has been suspended due to fraud or abuse from the Medicare or Medicaid (including Medi-Cal) programs; or
  • The provider’s license or certificate to provide health care has been surrendered or revoked.
The Department of Industrial Relation’s (DIR’s) fraud prevention efforts are posted online, including frequently updated lists for physicians, practitioners, and providers who have been issued notices of suspension, and those who have been suspended pursuant to Labor Code §139.21(a)(1). The department recently added a new web page with information on lien consolidations and the Special Adjudication Unit.


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MEDICAL BOARD RECORD—A 105496


DISCIPLINARY ACTIONSLicense renewed & current; Limits on practice

UNITED STATES DISTRICT COURT FOR THE CENTRAL DISTRICT OF CALIFORNIA ISSUED AN ORDER IN CASE NO. 12-01170(B)-MWF-6, THE UNITED STATES OF AMERICA VS. UCHE CHUKWUDI. DR. CHUKWUDI IS PROHIBITED FROM SEEING, TREATING OR PRESCRIBING OR ORDERING SERVICES OR ITEMS FOR MEDICARE PATIENTS AND PROHIBITED FROM PRESCRIBING CONTROLLED SUBSTANCES, INCLUDING HYDROCODONE (VICODIN) AND CODEINE FOR ANY PATIENTS.—7/29/2014


OIG Fugitive: Uche Chukwudi

(Office of Inspector General—US Dept of Health & Human Services)
  • On December 19, 2013, Dr. Uche Chukwudi was indicted on charges of health care fraud and conspiracy to commit health care fraud. Investigators believe that Dr. Chukwudi was involved in a scheme to fraudulently bill Medicare approximately $7.3 million for durable medical equipment (DME) that was never provided and was medically unnecessary.
  • Co-conspirator Adeline Ekwebelem owned Adelco Medical Distributors, a DME supplier in Gardena, California. According to the indictment, Ekwebelem paid marketers to solicit Medicare beneficiaries and offer them free DME, such as power wheelchairs, hospital beds, and orthotics, that they did not need. In return for the free products, the beneficiaries agreed to visit certain physicians, including Dr. Chukwudi, who would then use their beneficiary information to create false patient files and false statements in “face-to-face examination” forms. Dr. Chukwudi and other physicians then wrote prescriptions for the DME to be filled at Adelco.
  • Dr. Chukwudi referred more than 200 Medicare beneficiaries to Adelco for expensive, medically unnecessary DME, which enabled Ekwebelem to falsely bill Medicare for approximately $1.18 million. Dr. Chukwudi allegedly received cash kickbacks in return for writing the fraudulent prescriptions.
  • Ekwebelem was convicted on charges of conspiracy to commit health care fraud, health care fraud, and paying kickbacks for the recruitment of Medicare beneficiaries. Dr. Charles Okoye, a physician who referred more than 200 beneficiaries to Adelco, pleaded guilty to conspiracy to commit health care fraud. Both are awaiting sentencing. Patient recruiters Cindy Santana, Maritza Hernandez, and Romie Tucker, Jr., each pleaded guilty to illegal remunerations for health care referrals. Hernandez received 9 months in jail, while Santana and Tucker are awaiting sentencing.
  • Dr. Chukwudi fled the United States prior to his trial in September 2014. His whereabouts are currently unknown, and he remains a fugitive at-large.
CALIFORNIA—A Hawthorne woman responsible for more than $7 million in fraudulent Medicare billings, mostly for expensive power wheelchairs, was found guilty Friday of 16 federal charges stemming from the health-care fraud scheme.

Adeline Ekwebelem, 51, was convicted following a seven-day trial before U.S. District Judge Michael W. Fitzgerald, who set a Dec. 15 sentencing hearing in federal court.

Ekwebelem was found guilty of conspiracy to commit health-care fraud, a dozen counts of health-care fraud and three counts of paying illegal kickbacks for health-care referrals, according to the U.S. Attorney’s Office.

She is the fifth person convicted in relation to the scheme run out of her Gardena-based Adelco Medical Distributors Inc.

Evidence presented during the trial showed that Adelco billed Medicare for medically unnecessary equipment for beneficiaries who were often recruited off the street.

Ekwebelem paid illegal kickbacks to people known as marketers to recruit those beneficiaries. She also paid kickbacks to a handful of complicit doctors in exchange for fraudulent prescriptions for the wheelchairs.

Those doctors included Dr. Charles Okoye, who pleaded guilty last month, and Dr. Uche Chukwudi, who fled after being indicted and is a fugitive, prosecutors said.

Three of Adelco’s marketers — Romie Tucker, Cindy Santana and Maritza Hernandez — have also pleaded guilty to receiving kickbacks from Ekwebelem.
Ekwebelem submitted more than $7 million in fraudulent claims to Medicare and received nearly $3.5 million for those claims. (LINK) — 9/19/2014