According to a Department of Justice press release, a Houston, Texas registered nurse pleaded guilty on Friday, March 17, 2017 for his role in a $5 million Medicare home health fraud scheme involving paying illegal kickbacks to patient recruiters in return for home health patient referrals.

The nurse, Charles Esechie, 47, of Katy, Texas, pleaded guilty before U.S. District Judge Sim Lake of the Southern District of Texas to one count of conspiracy to commit health care fraud. Esechie is scheduled to be sentenced by Judge Lake on Aug. 17, 2017.

According to his plea agreement, Esechie worked as a nurse for both Harris County, Texas, Hospital District (Harris County) and Baptist Home Care Providers Inc. (Baptist), one of five Houston-area home healthcare agencies owned by Godwin Oriakhi, the alleged leader of the home health fraud scheme.  Esechie admitted that while he worked at Baptist, he knew that Oriakhi obtained Medicare patients by paying illegal kickback payments to patient recruiters for referring patients to Baptist for home healthcare services that Esechie knew were medically unnecessary and often not provided.  Esechie also admitted that he knew that some of patients referred by the patient recruiters were homeless, and that many patients stayed at Baptist in order to receive kickbacks from Oriakhi rather than actual healthcare.

Esechie further admitted that he completed Baptist’s Medicare documents while working full time as a Harris County nurse, often claiming that he was evaluating patients for Baptist at times when he was actually across town working at a Harris County hospital. To avoid actually having to travel to the homes of Baptist’s patients for evaluations, Esechie admitted that he copied patient and medical information from templates created for him by Orikahi and Baptist’s office staff onto Baptist’s Medicare documents. Esechie also admitted that he saw patients in groups at the home of one of Oriakhi’s patient recruiters and conducted perfunctory examinations that lasted approximately five to 10 minutes, but overbilled Medicare for comprehensive examinations.

Jermaine Doleman, a patient recruiter and Idia Oriakhi, Godwin Oriakhi’s daughter and administrator of several of his home health agencies have also pleaded guilty and are awaiting sentencing for their roles in the scheme.  Godwin Oriakhi is charged with conspiracy, health care fraud, paying illegal kickbacks and money laundering offenses for his alleged role in the schemes and is scheduled for trial on April 11, 2017.

The FBI, HHS-OIG, IRS-CI and MFCU investigated the case, which was brought by the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Texas.

The cases against Esechie and his co-conspirators are criminal cases.  However, under the qui tam provisions of the False Claims Act, whistleblowers — known as “relators” — with information about similar fraud against the government may bring a civil case on behalf of the United States. If successful, the government can recover three times the amount the defendants fraudulently billed the government.  The whistleblower, who originally filed the case, is entitled to 15-30% of the government’s recovery as well as their attorney’s fees.

For instance, Frohsin Barger and Walthall served as lead relators’ counsel in the largest home health care fraud case in United States history, United States ex rel. Brown v. Amedisys, Inc. et al., 13-cv-2803 (E.D. Pa.). That case recovered a total of $150 million for the U.S. taxpayers and Frohsin Barger & Walthall client April Brown received $15 million.  

To learn more about home health fraud click here.