Nigerian jailed, fined $1m for $8.3m healthcare fraud in US

A United States court has sentenced a Nigerian, Ayodeji Fatunmbi, to 46 months in prison for defrauding the US government over $8million Medicare charges.

A statement from the US Department of Justice said the 47-year-old was sentenced for his role in a Durable Medical Equipment (DME) scheme in which the money was fraudulently billed for DME that was not medically necessary.

US District Judge Christina Snyder of the Central District of California sentenced Fatunmbi and ordered him to pay $1,076,893.15 in restitution.

On May 8, the defendant pleaded guilty to one count of conspiracy to commit healthcare fraud and one count of conspiracy to commit money laundering.

He was charged along with two others – Olufunke Fadojutimi, 47, of Carson, California, and Maritza Velasquez, 44, of Las Vegas, Nevada. As part of his guilty plea, Fatunmbi was said to have admitted that he and the others paid cash kickbacks to patient recruiters and physicians for fraudulent prescriptions for DME such as power wheelchairs, which the Medicare beneficiaries did not have a legitimate medical need.

He and his co-conspirators also caused Lutemi Medical Supply (Lutemi), a DME supply company that he co-ran, to submit approximately $8.3 million in claims to Medicare, which resulted in the company being paid over $3.5 million.

“Fatunmbi further admitted that he was responsible for $2,090,434 in false and fraudulent claims for medically unnecessary DME and that as a result of his conduct, Medicare paid Lutemi a total of $1,076,893.

“In furtherance of this scheme, Fatunmbi and a co-conspirator wrote cheques from Lutemi’s bank account to Lutemi employees and others, and Fatunmbi instructed that those monies be returned to him to pay the illegal cash kickbacks to the patient recruiters and doctors, he admitted.

“Fatummbi admittedly directed others at Lutemi to engage in these transactions to conceal the nature and source of the proceeds of the health care fraud conspiracy,” the statement said.

Velasquez, on the other hand, pleaded guilty on July 24, 2013, to one count of conspiracy to commit health care fraud, and was sentenced to 15 months in prison and restitution in the amount of $3,411,428.

The US Department of Justice said Fadojutimi was found guilty after a jury trial on July 31, 2014, of one count of conspiracy to commit healthcare fraud, seven counts of healthcare fraud, and one count of money laundering, and was sentenced to four years in prison and restitution in the amount of $4,372,466.

This case, it noted, was investigated by the HHS-OIG, the FBI and IRS-CI while trial attorneys Claire Yan, Emily Culbertson and Justin Givens of the Criminal Division’s Fraud Section were prosecuting it.

“The Asset Forfeiture Section of the U.S. Attorney’s Office for the Central District of California is handling the asset forfeiture aspects of the case,” the statement added.

According to the justice department, the Fraud Section leads the Medicare Strike Force, which is part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country.

Since its inception in March 2007, the Medicare Fraud Strike Force, which maintains 14 strike forces operating in 23 districts, has charged nearly 4,000 defendants who have collectively billed the Medicare programme for more than $14 billion.

In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

Assistant Attorney General Brian Benczkowski of the Justice Department’s Criminal Division, US Attorney Nicola Hanna of the Central District of California, Special Agent in Charge Timothy DeFrancesca of the US Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Los Angeles Regional Office, Assistant Director in Charge Paul Delacourt of the FBI’s Los Angeles Division, and Special Agent in Charge Ryan Korner of IRS Criminal Investigation (IRS-CI) Los Angeles Field Office, made the announcement on Monday.

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