Jury Convicts Oakland, California Patient Recruiter for Participating in Wheelchair Scam to Defraud Medicare
|U.S. Department of Justice November 23, 2010|
WASHINGTON—An Oakland, Calif., woman was convicted of health care fraud in connection with a scheme to bill Medicare for power wheelchairs that were medically unnecessary, announced the Departments of Justice and Health and Human Services (HHS).
On Monday, after a one-week trial in federal court in Los Angeles, a jury found Donna K. Wells, 52, guilty of one count of health care fraud. The evidence introduced at trial showed that Wells worked the streets and low-income, senior living communities of Oakland to recruit Medicare beneficiaries to bill Medicare for expensive power wheelchairs and other durable medical equipment (DME) which the beneficiaries did not want, need or use. The beneficiaries who testified at trial said that Wells approached them on the street, at the store, or in the lobby of their apartment buildings and offered them free power wheelchairs in exchange for the beneficiaries allowing Wells to copy their Medicare and California identification cards. One beneficiary testified that when she told Wells that she wanted a hospital bed and did not need or want a power wheelchair, Wells said that the beneficiary had to accept a power wheelchair in order to get a hospital bed. Based on that representation, the beneficiary agreed to accept both a power wheelchair and a hospital bed even though she did not need and never used the wheelchair.
Witnesses who lived in or worked at the San Pablo Hotel, one of the low-income senior living communities where Wells illegally recruited beneficiaries, testified that Wells often sat in the lobby of the hotel offering residents free power wheelchairs and copying their Medicare and California identification cards. These and other witnesses testified that many of the residents of the San Pablo Hotel did not use the power wheelchairs they received through Wells.
According to testimony at trial, Wells sold the beneficiaries' Medicare information to others. Witnesses testified that Wells charged them between $400 and $500 for the Medicare information of each beneficiary she recruited. One witness testified that over a four-year period, Wells sold the witness the Medicare information of approximately 200 different beneficiaries. Once these witnesses received the Medicare information from Wells, they sold the information to a fraudulent medical clinic in Los Angeles, which then used the information to fabricate fraudulent prescriptions for power wheelchairs and other DME in the names of the beneficiaries whom Wells recruited. One of the doctors whose name appeared on these fraudulent prescriptions testified that he never wrote the prescriptions or treated any of the Oakland beneficiaries whom Wells recruited.
Witnesses testified that they purchased the fraudulent power wheelchair and DME prescriptions from the fraudulent medical clinic, and then sold both the Medicare information they received from Wells and the fraudulent prescriptions for more than $1,000 per prescription to a number of Los Angeles-area DME supply companies. These DME supply companies used the beneficiaries' information and the fraudulent prescriptions to submit claims to Medicare for power wheelchairs which cost Medicare approximately $4,000 per wheelchair but cost the DME supply companies approximately $900 per wheelchair wholesale. Evidence introduced at trial showed that these DME supply companies submitted more than $577,000 in false power wheelchairs claims to Medicare. Several beneficiaries testified at trial that they did not need and rarely, if ever, used their power wheelchairs.
One of the DME supply companies that used the Medicare information from Wells was Maydads Medical Supply of Arleta, Calif. Trial evidence established that between June 2007 and August 2009, Maydads Medical Supply submitted approximately $470,973 in false and fraudulent claims to Medicare, almost all of which were for power wheelchairs. The owner and operator of Maydads Medical Supply, Sylvester Ijewere, pleaded guilty to health care fraud and was sentenced on Oct. 5, 2010, to 46 months in prison.
Wells was originally charged in October 2009 with three counts of health care fraud. The jury was unable to reach a verdict on two of the three counts. U.S. District Court Judge Dales S. Fischer scheduled Wells' sentencing for March 28, 2011. Wells faces a maximum penalty of 10 years in prison and a $250,000 fine.
Today's guilty verdict was announced by Assistant Attorney General Lanny A. Breuer of the Criminal Division; U.S. Attorney André Birotte Jr. for the Central District of California; Tony Sidley, Assistant Chief of the California Department of Justice, Bureau of Medi-Cal Fraud and Elder Abuse; Glenn R. Ferry, Special Agent-in-Charge for the Los Angeles Region of the Office of Inspector General for HHS (HHS-OIG); and Steven Martinez, Assistant Director in Charge of the FBI's Los Angeles Field Office.
The case was prosecuted by Trial Attorney Jonathan Baum and Senior Trial Attorney John Michelich of the Criminal Division's Fraud Section. The case was investigated by the California Department of Justice. HHS OIG assisted with the trial. The case was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division's Fraud Section and the U.S. Attorney's Office for the Central District of California. Since their inception in March 2007, Strike Force operations in seven districts have obtained indictments of more than 825 individuals who collectively have falsely billed the Medicare program for more than $2 billion. In addition, HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to: www.stopmedicarefraud.gov