Qui Tam

Houston Medical Equipmant owner charged in $3M Medicare Fraud Scheme

By LaBovick Law

The former owner and operator of a medical equipment company, Helen Etinfoh was sentenced to 41 months in prison for her role in $3 million Medicare fraud scheme. The 50-year-old Etinfoh will  pay $851,228 in restitution and have a supervised release for three years after her prison term. 

The Medical equipment company, Luant & Odera Inc., worked with Paula Whitfield to commit health care fraud. Etinfoh was convicted of health care fraud. Whitfield was a patient recruiter for the company and was paid in exchange for giving the names of beneficiaries whose bills could be submitted to Medicare. All of the accused conspirators were charged with submitting false claims to Medicare for unnecessary equipment, including power wheelchairs and related accessories.

After the Houston area hurricane in 2008, a hurricane code was used that allowed the company to directly file with Medicare without a doctor's order. However, the medicare claims were fraudulently submitted, because the hurricane did not damage the wheelchairs involved in the  case. In evidence produced at the trial, beneficiaries stated that they did not own power wheelchairs before receiving new ones.

Beneficiaries testified that Whitfield and others would come to their homes and offer free wheelchairs from Medicare. Surprisingly, none of beneficiaries needed the wheelchairs, since they could walk perfectly fine. The fraud ring billed Medicare as much as $6,000 per chair.

Since March of 2007, over 1,000 indictments have been filed against individuals who have falsely billed the Medicare program. The government has been able to collect $2.3 billion in recovery from Medicare fraud. The government is taking a stand to thwart unscrupulous providers from bilking the system with fraudulent claims. Thanks to whistleblowers coming forward, Medicare fraud is being reported.

Whistleblowers should seek an experienced qui tam attorney to discuss their potential whistleblower claim. As mentioned previously on the whistleblower law blog, a successful qui tam outcomes can result in substantial settlements or judgments. A whistleblower may be entitled to a whistleblower reward reward of 15-25% due to provisions in the False Claims Act. 

If the government does not intervene in the case, the whistleblower can pursue the case, and may be entitled to a whistleblower reward of 25-30%.  A qui tam attorney can evaluate the strength of the complaint and protect the privacy, rights and interests of those clients with a legitimate whistleblower claim.

Full post as published by Whistleblower Law Blog on March 12, 2011 (boomark / email).