Physician and Patient Recruiter Plead Guilty to $10.1M in Power Mobility Medicare Fraud

A Los Angeles-area doctor and a patient recruiter pleaded guilty last week for their roles in a power wheelchair fraud scheme that defrauded Medicare of over $10.1 million.

The plea was announced by Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division; United States Attorney André Birotte Jr of the Central District of California; Glenn R Ferry, Special Agent in Charge for the Los Angeles Region of the United States Department of Health and Human Services Office of Inspector General (HHS-OIG); Steven Martinez, Assistant Director in Charge of the FBI’s Los Angeles Field Office; and Joseph Fendrick, Special Agent in Charge of the California Department of Justice, Bureau of Medi-Cal Fraud and Elder Abuse. Dr. Emmanuel Ayodele, 65, of Los Angeles, and Alejandro Maciel, 43, of Huntington Park, California, pleaded guilty before United States District Judge George Wu in the Central District of California to one count of health care fraud and one count of conspiracy to commit health care fraud, respectively.

Ayodele admitted that he defrauded Medicare by participating in a power wheelchair fraud scheme with the operators of fraudulent durable medical equipment (DME) supply companies. According to court documents, DME suppliers provided Ayodele with patients recruited by street-level patient recruiters or “marketers,” who illegally solicited people with Medicare benefits for power wheelchairs and other DME that the people did not need. In court documents, Maciel admitted that he was one of these marketers. Maciel admitted that he approached people at their homes, swap meets, grocery stores, and other locations and made various misrepresentations to the people about his true identity and Medicare.

Maciel admitted that these misrepresentations allowed him to gain the trust of Medicare beneficiaries and convince them to provide him with their Medicare billing and personal information, which Maciel, Ayodele, and their co-conspirators used to defraud Medicare. Maciel also admitted that, through his misrepresentations, he convinced people to travel with him to fraudulent medical clinics and DME supply companies owned and operated by his co-conspirators. Ayodele admitted that he owned one of these fraudulent medical clinics, Beth Medical Clinic, which he operated in Los Angeles. Ayodele admitted that, at Beth Medical, he wrote medically unnecessary prescriptions for power wheelchairs and DME.

Ayodele admitted he knew that the DME supply companies used the medically unnecessary prescriptions and documents that he wrote to submit claims to Medicare for medically unnecessary power wheelchairs and DME. For example, Ayodele admitted that the operators of fraudulent DME supply company Bonfee Inc ., who were indicted with Ayodele and Maciel on Medicare fraud charges, paid Ayodele to write a medically unnecessary power wheelchair prescription for one of Bonfee’s customers and then used that prescription to submit a false power wheelchair claim to Medicare that totaled over $6,000. Maciel admitted that his profit from the scheme came in the form of illegal kickbacks paid to him for every person whose Medicare billing and personal information his co-conspirators successfully used to bill Medicare for power wheelchairs or other items of DME. According to court documents, once his co-conspirators successfully billed Medicare, Maciel delivered the power wheelchairs and other DME to the people whom he recruited.

During these deliveries, Maciel observed that the people could walk and that they did not have a legitimate need for the wheelchairs and other DME. As a result of their conduct, Ayodele and Maciel admitted that they and the owners and operators of Bonfee, Lutemi Medical Supplies, and other fraudulent DME companies submitted and caused to be submitted over $10,132,178 in false and fraudulent claims to Medicare. Ayodele and Maciel admitted that Medicare paid Bonfee and the other DME supply companies over $5,388,754 on these false and fraudulent claims.

Two of Ayodele and Maciel’s co-defendants, Charles Agbu, a former pastor who owned Bonfee, and Dr. Juan Van Putten, have pleaded guilty to Medicare fraud charges and are scheduled for sentencing on August 15, 2013, and September 26, 2013, respectively. Ayodele and Maciel’s other co-defendants, Obiageli Agbu and Candalaria Estrada, are scheduled for trial on July 9, 2013. The owner of Lutemi, Olufunke Fadojutimi, a registered nurse, was arrested on May 14, 2013, on Medicare fraud charges. Fadojutimi is scheduled for trial on October 22, 2013.

Defendants are presumed innocent unless proven guilty in court. At sentencing, scheduled for September 30, 2013, Ayodele and Maciel each face a maximum penalty of 10 years in prison and a $250,000 fine. The case is being prosecuted by Trial Attorneys Jonathan T Baum, Alexander Porter, William Kanellis and Blanca Quintero of the Criminal Division’s Fraud Section. The case is being investigated by the FBI, HHS-OIG, and the California Department of Justice.

DME Billing Service
Provider of Professional
DME Billing Services

DME Billing News Feed:

DME Billing Services MedBill Twitter
DME Billing Service News

Retrieved From: