Rough week for Fort Bend County residents as federal investigations reveal $19 million Medicare fraud

By LeaAnne Klentzman

In an indictment issued by a federal grand jury Fort Bend businessman Joseph Edem, 53, of Richmond and Dr. Donald Gipson II, 56, of Sugar Land have been charged with healthcare fraud and conspiracy to commit healthcare fraud in a scheme that involved unnecessary diagnostic testing and physical therapy. Both Edem and Gipson were arrested last Thursday and taken before U.S. Magistrate Judge Mary Milloy.

According to US Attorney Kenneth Magidson the indictments were based on Dr. Gibson ordering, prescribing and authorizing medically unnecessary diagnostic tests and other procedures which included allergy tests, pulmonary function tests, vestibular tests, urodynamic tests and physical therapy, among others. Then billing these services to Medicare and Medicaid for payment under Gibson’s billing number.

Based on the federal and state investigation, Gibson allegedly caused more than $19.4 million in medical claims to the Medicare and Texas Medicaid Programs from January 2007 through January 2012.  Those “unnecessary” billing charges to Medicare resulted in deposits of approximately $8.5 million into a bank account owned and controlled by Gibson, said federal officials.

The indictment against Edem alleges that he operated medical clinics under the names of other individuals to conceal his financial interest in the businesses. “Edem and Gibson allegedly conspired with one another to cause the submission of false claims to the Medicare and Medicaid programs and share in the proceeds,” said Magidson.

Gibson and Edem are also accused of paying patient recruiters for referring Medicare/Medicaid beneficiaries, as well as Medicare beneficiaries for showing up at the medical clinics. The cases against Gipson and Edem are just beginning their trek through the federal justice system.

In a case that has been winding its way to the end of the federal justice system, a Richmond area Chiropractor finds herself sentenced to federal prison.

On May 25, 2012, Justina Okehie, aka Dr. Tina Collins, of Richmond, Texas, was sentenced to federal prison for her role in a multi-million-dollar health care fraud scheme according to US Attorney Kenneth Magidson.  Okehie entered a plea of guilty on October 27, 2011. Last week she was sentenced to a 24 month federal prison sentence and ordered her to pay restitution in amount of $1,894,938 to the Medicare Program and $258,893 to the Texas Medicaid program.

When handing down her sentence, Judge Atlas stated, “Medicare fraud is the worst around,” saying that Okehie lived her life by cheating the system and living off this fraud. Okehie will also serve a two-year term of supervised release following completion of her prison sentence.

Okehie, 55, owned and operated Adom Rehabilitation Services and Healthcare and Wellness Medical Center, both located in southwest Houston.  Both facilities purportedly offered physical therapy and chiropractic services. Reportedly, as part of the conspiracy, Okehie would pay patient recruiters (aka runners or marketers) for referring Medicare beneficiaries to her clinics. Okehie also paid remuneration to the Medicare beneficiaries to induce them to show up at her clinics.  From January 2007 through August 2010, Okehie submitted claims to the Medicare and Medicare programs in excess of $8.5 million.

Okehie’s co-defendants Cassandra Tasby Barnes, 48, of Houston, and Melloneen Davis, 53, of Stafford, Texas, were each previously convicted for their roles in a conspiracy to violate the anti-kickback statute. Barnes and Davis each were sentenced to three years’ probation and four months of home confinement. Both were ordered to pay restitution in the amount of $42,052.48 to Medicare and $8,338.68 to the Texas Medicaid Program.

Both cases involved joint investigations by U.S. Department of Health and Human Services-Office of Inspector General, the Texas Attorney General’s Medicaid Fraud Control Unit, FBI, and the Railroad Retirement Board.

Special Assistant U.S. Attorney Justin Blan and Assistant U.S. Attorney Julie Redlinger prosecuted this case.

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Posted by on May 30 2012. Filed under Breaking News. You can follow any responses to this entry through the RSS 2.0. You can skip to the end and leave a response. Pinging is currently not allowed.

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