Houston, Texas - The former Director of Nursing and Administration of two Houston, Texas-based businesses was sentenced Thursday to 10 years in prison for her role in a $20 million Medicare fraud scheme involving false and fraudulent claims for home health services.
Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Ryan K. Patrick of the Southern District of Texas, Special Agent in Charge Perrye K. Turner of the FBI’s Houston Field Office and Special Agent in Charge C.J. Porter of the U.S. Department of Health and Human Services-Office of Inspector General’s (HHS-OIG) Dallas Region made the announcement.
Evelyn Mokwuah, 54, of Pearland, Texas, former Director of Nursing and Administration of Beechwood Home Health (Beechwood) and Criseven Health Management Corporation (Criseven), both located in Houston, was sentenced by U.S. District Judge Gray H. Miller of the Southern District of Texas. Judge Miller also ordered Mokwuah to pay $20,462,607.21 in restitution to Medicare. On Aug. 10, 2017, following a four-day trial, a jury found Mokwuah guilty of one count of conspiracy to commit health care fraud and four counts of health care fraud.
According to evidence presented at trial, from 2008 to 2016, Mokwuah and others engaged in a scheme to defraud Medicare of approximately $20 million including the submission of fraudulent claims for home health services at Beechwood and Criseven that were not provided, not medically necessary or both. According to the trial evidence, Mokwuah falsely certified and billed for patients who were not homebound or did not qualify for home health services. Along with others, Mokwuah also falsified patient records to show that patients were homebound when they were not; paid patient recruiters to recruit Medicare beneficiaries to Beechwood and Criseven; and paid doctors to certify false plans of care for Medicare beneficiaries so that Beechwood and Criseven could bill Medicare for those services.
The case was investigated by the FBI and HHS-OIG, and was brought as part of 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 case is being prosecuted by Trial Attorneys Scott Armstrong and Kevin Lowell of the Fraud Section.
The Fraud Section leads the Medicare Fraud Strike Force. 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 program for more than $14 billion. In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.