Friday, September 6, 2013
Cedar Hill Man Ordered to Prison for Health Care Fraud in Case Investigated by State and Federal OfficialsThe U.S. Attorney for the Northern District of Texas issued the following news release on Sept. 5, 2013:
Sentenced to 10 Years in Federal Prison for Role in Health Care Fraud Conspiracy
Defendant Also Ordered to Pay More Than $25 Million in Restitution
DALLAS — Cyprian Akamnonu, 64, of Cedar Hill, Texas, was sentenced this morning by U.S. District Judge Sam A. Lindsay to the statutory maximum of 10 years in federal prison and ordered to pay $25,466,779 in restitution, following his guilty plea in October 2012 to one count of conspiracy to commit health care fraud. Today’s announcement was made by U.S. Attorney Sarah R. Saldaña of the Northern District of Texas.
In handing down the sentence and in response to a plea for leniency, Judge Lindsay stated, “For persons out there who are inclined to commit health care fraud, a low sentence in this case would have no deterrent effect.” Judge Lindsay also ordered that Akamnonu, who is in custody, forfeit the following property to the government: four vehicles, 21 parcels of real estate located in Dallas, Cedar Hill and Grand Prairie, Texas and funds in several business and personal bank accounts.
According to documents filed in the case, Akamnonu and his wife/business partner/co-defendant, Patricia Akamnonu, R.N., co-owned Ultimate Care Home Health Services. Akamnonu admits that from January 2006 through November 2011, he conspired with co-defendants Dr. Jacques Roy and others to defraud Medicare in connection with the delivery of, and payment for, health care benefits, items and services.
A trial date of January 13, 2014, is set for Akamnonu’s co-defendants, Dr. Roy, Patricia Akamnonu, Cynthia Stiger, Wilbert James Veasey, Teri Sivils and Charity Eleda.
According to documents filed in the case, at Akamnonu’s direction, his wife Patricia, and others, recruited Medicare beneficiaries to Ultimate to receive home health care services for which they did not qualify and did not need. Akamnonu and others would approach people throughout Dallas-area neighborhoods to see if they were qualified Medicare beneficiaries, and if they were, they would attempt to sign them up for home health services.
Once a beneficiary was recruited, Akamnonu would take paperwork to Sivils and other employees of Medistat Group Associates, PA., to be signed on behalf of Dr. Roy, certifying that the Medicare beneficiary was under Dr. Roy’s care, homebound and in need of skilled nursing services, thus allowing Ultimate to bill Medicare for the skilled nursing services. Akamnonu and Dr. Roy had an agreed-upon, fraudulent arrangement in which Ultimate provided Dr. Roy with the beneficiaries to bolster Medistat’s patient roster in exchange for Roy’s certification for skilled nursing services of any beneficiary sent to him. In addition, Sivils signed Ultimate’s paperwork on behalf of Dr. Roy because Akamnonu paid her cash kickbacks in exchange for doing so.
At Akamnonu’s direction, nurses would perform cursory visits to the beneficiaries at their homes that bore little relationship to the skilled nursing services for which the beneficiaries had been certified. Then, at Akamnonu’s direction, Ultimate would bill Medicare for skilled nursing services that were not necessary and were never in fact provided.
During this five-year period, more than 72% of Ultimate’s beneficiaries were certified by Dr. Roy or another Medistat physician acting at his direction. Ultimate billed more than $40 million to Medicare for skilled nursing services for these beneficiaries and Dr. Roy, in turn, incorporated these patients into his own practice and billed more than $2.3 million for services related to them.
The case is being investigated by the FBI, the U.S. Department of Health and Human Services - Office of Inspector General (HHS-OIG) and the Texas Attorney General’s Medicaid Fraud Control Unit and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division Fraud Section and the U.S. Attorney’s Office for the Northern District of Texas.
Assistant U.S. Attorneys Michael C. Elliott, Mindy Sauter, P. J. Meitl and John DeLaGarza are in charge of the prosecution.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,500 defendants who have collectively billed the Medicare program for more than $5 billion. In addition, HHS’s Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the HEAT Strike Force, please visit: www.stopmedicarefraud.gov.