Owners of Home Health Care Agency Found Guilty of Taking Part in $80 Million Medicaid Fraud
WASHINGTON—Florence Bikundi, and her husband, Michael Bikundi, the owners of Global Healthcare, Inc., a home care agency, have been found guilty by a jury of health care fraud, money laundering, and other charges stemming from a scheme in which they and others defrauded the District of Columbia Medicaid program of over $80 million.
The verdicts were announced by Channing D. Phillips, U.S. Attorney for the District of Columbia; Paul M. Abbate, Assistant Director in Charge of the FBI’s Washington Field Office; Nicholas DiGiulio, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), for the region that includes Washington, D.C.; James M. Murray, Special Agent in Charge, Washington Field Office, U.S. Secret Service; and Daniel W. Lucas, Inspector General for the District of Columbia.
The verdicts were returned on Nov. 12, 2015, and followed more than four weeks of trial in the U.S. District Court for the District of Columbia. The Honorable Beryl A. Howell scheduled sentencing for Feb. 26, 2016. The charges carry statutory maximums of decades in prison. In addition to prison terms, Florence and Michael Bikundi are subject to a forfeiture money judgment equal to the total proceeds they acquired as a result of this scheme. Judge Howell also will determine if the Bikundis must forfeit $11 million seized from various bank accounts, their home in Mitchellville, Md., and five luxury vehicles.
“Over a period of more than four years, Florence and Michael Bikundi raided the Medicaid program of $80 million through massive and systematic fraud,” said U.S. Attorney Phillips. “The money they stole for their own benefit could and should have been used to help others who were truly in need. Instead, they used the proceeds to finance a lavish lifestyle, including a million-dollar home, a $140,000 Land Rover, a $120,000 Porsche, and a $75,000 Mercedes Benz. This prosecution reflects our determination to protect taxpayer dollars and the citizens of the District of Columbia. Together with our law enforcement partners, we will actively combat health care fraud.”
“These defendants defrauded government health care programs designed to provide for those in need,” said Assistant Director in Charge Abbate of the FBI. “The relentless work of agents, analysts, and prosecutors exposed this conspiracy to steal government funds and brought to justice those responsible. The FBI and our law enforcement partners will continue to work aggressively to prevent and uncover fraud targeting the Medicaid program and maintain the integrity of our nation’s health care system.”
“It’s outrageous that these fraudsters would steal tens of millions of Medicaid dollars meant to provide health care services to poor and disabled individuals just to enrich themselves,” said Special Agent in Charge DiGiulio, of the HHS Office of Inspector General. “Our agency is dedicated to uprooting such fraud schemes and bringing criminals to justice.”
“The recent verdicts in this Medicaid fraud case demonstrate the effectiveness of law enforcement partnerships in the dismantling of criminal enterprises defrauding American health care systems which ultimately impact American citizens,” said Special Agent in Charge Murray of the U.S. Secret Service. “This investigation and the resulting arrests should alert criminals that law enforcement will not cease to pursue them.”
“My Office is fully committed to defending the public from people seeking to defraud the District government,” said Inspector General Lucas of the District of Columbia. “This verdict demonstrates that the OIG plays a lead role, in concert with our District, state, and federal partners, in aggressively investigating and prosecuting health care providers who unlawfully enrich themselves at D.C. taxpayers’ expense. I would like to thank all of the staff from my Medicaid Fraud Control Unit for having tirelessly pursued this case since 2009. Without their tenacity through this long investigation and trial, the District would not be able to recoup the money fraudulently paid to Global and its principals.”
Florence Bikundi, 52, also known as Florence Ngwe and Florence Igwacho, has been in custody since her arrest in February 2014. She was found guilty by the jury of 12 charges: one count of conspiracy to commit health care fraud; one count of conspiracy to commit money laundering, two counts of health care fraud; one count of Medicaid fraud; and seven counts of money laundering. Michael D. Bikundi, Sr., 63, was found guilty of 10 charges: one count of conspiracy to commit health care fraud; one count of conspiracy to commit money laundering, one count of health care fraud; and seven counts of money laundering.
According to evidence presented at trial, Florence Bikundi, a former nurse, and her husband owned Global Healthcare, Inc. According to the government’s evidence, Florence Bikundi was not entitled to take part in the Medicaid program and fraudulently got approval as a provider. Then, the government’s evidence showed, she and her husband led a scheme to bill Medicaid for services that never were provided—recruiting others, including family members, into the scam, and creating fraudulent paperwork to hide the illegal activity.
The D.C. Medicaid program is funded jointly by District of Columbia tax dollars and federal tax dollars. Medicaid provides for home care services to be performed by personal care aides, working for eligible home care agencies. Doctors or advanced practice registered nurses must examine beneficiaries and authorize them to receive these services. The aides are to follow a plan of care and assist Medicaid beneficiaries in performing activities of daily living, such as getting in and out of bed, bathing, dressing, keeping track of medication, and so forth.
In 1999, Florence Bikundi went by her maiden name of Florence Igwacho. In August 1999, the Virginia Board of Nursing revoked the nursing license of Florence Igwacho. In March 2000, the U.S. Department of Health and Human Services, Office of Inspector General notified Florence Igwacho in writing that she was excluded from participation in Medicare, Medicaid, and all federal health care programs due to the revocation.
Florence Bikundi subsequently concealed her past—namely, the Medicaid exclusion and the revocation of her nursing license—when she applied for a Medicaid provider number for Global Healthcare in June 2009 using the name of Florence Bikundi. She also used three forged signatures on her Medicaid provider application. Florence Bikundi married Michael Bikundi in September 2009.
From August 2009 through February 2014, Florence and Michael Bikundi used Global HealthCare to carry out a massive fraud, the government’s evidence showed. Year after year, the D.C. Medicaid program was billed for personal home health aide services that were not provided to Medicaid beneficiaries. Phony time sheets, patient files and employment files were created. Global Healthcare generated increasing amounts of payments as the years continued, going from roughly $1.35 million in 2009 to $14.27 million in 2011 to $27.16 million in 2013.
According to the government’s evidence, the Bikundis used the proceeds to finance a lavish lifestyle. In just over three years, they spent $1.3 million to purchase and renovate a newly built home. They also used the proceeds for a $140,000 Land Rover, a $120,000 Porsche, a $75,000 Mercedes Benz, a $70,000 Cadillac and a $36,000 BMW.
Seven others earlier pled guilty to charges in the investigation, including Florence Bikundi’s son, and Florence Bikundi’s two sisters.
Bikundi was among 25 people charged in February 2014 following a wide-ranging investigation that uncovered numerous, separate schemes involving fraud, kickbacks, and false billings in the growing field of home care services for D.C. Medicaid beneficiaries. So far, 23 defendants have either pled guilty or been found guilty of charges. Those pleading guilty include people who worked as personal care aides in the home care industry, patient recruiters who demanded money for access to Medicaid beneficiaries, and others.
The various investigations were conducted by the FBI’s Washington Field Office; the U.S. Department of Health and Human Services, Office of Inspector General; the U.S. Secret Service; the Medicaid Fraud Control Unit of the District of Columbia’s Office of the Inspector General; the Internal Revenue Service-Criminal Investigation; the U.S. Immigration and Customs Enforcement (ICE) Office of Homeland Security Investigations (HSI); the Office of Labor Racketeering and Fraud Investigations, Office of Inspector General, Department of Labor; the Social Security Administration, Office of Inspector General, and the Medicaid Fraud Control Unit of the Maryland Attorney General’s Office. Assistance was provided by the District of Columbia’s Department of Health Care Finance and other agencies.
This case was prosecuted by Assistant U.S. Attorneys Lionel A. André, Anthony Saler, and Michelle Bradford, of the Office’s Fraud and Public Corruption Section. Assistant U.S. Attorney Christopher B. Brown, of the Asset Forfeiture and Money Laundering Section, is assisting during the forfeiture proceedings. Criminal Investigator Nicole Hinson, also of the U.S. Attorney’s Office, was the prosecution’s law enforcement representative during the trial.
Assistance in this case and the other investigations was provided by Arvind K. Lal, Chief of the Asset Forfeiture and Money Laundering Section; Assistant U.S. Attorneys Zia Faruqui, Ted Radway, Michael Friedman, Chrisellen Kolb, and Michelle Zamarin; Financial Analyst Bryan J. Snitselaar; Deputy U.S. Marshal Wayne Rollock of the U.S. Marshals Service; Paralegal Specialists Toni Donato, Donna Galindo, Krishawn Graham, Tasha Harris, Corinne Kleinman, and Kristy Penny; Legal Assistants Angela Lawrence, Jessica McCormick, and Christopher Samson; Litigation Support Specialist Ron Royal, and former Forensic Accountant Maria Boodoo.