Charles Agbu, 58, a church pastor near Los Angeles, California has pleaded guilty in an $11 million Medicare fraud scam involving fraudulent medical clinics, doctors, and recruiters soliciting patients right off the street. The Department of Justice leveled the following allegations against Agbu:
The church pastor ran a fraudulent durable medical equipment (DME) supply company in Carson, California called Bonfee Inc. Agbu paid recruiters (“marketers”) to solicit Medicare beneficiaries in order to obtain their Medicare information. The marketers frequently told the Medicare patients that they would receive power wheelchairs (PWCs) in exchange for the Medicare information. The Medicare beneficiaries did not really need the PWCs, but the wheelchairs were expensive and generated the highest profits for Agbu and his co-conspirators.
Medicare will not reimburse a supplier for PWCs unless the supplier maintains prescriptions from a medical doctor for the PWCs. To get the needed prescriptions, Agbu paid fraudulent medical clinics to write out phony prescriptions and other necessary documentation for Agbu’s file. Each fraudulent prescription cost him from $400 to $700. Agbu also paid individual doctors who wrote phony prescriptions for the PWCs and other DME. These physicians received between $100 and $400 per prescription.
Agbu and his co-conspirators billed Medicare for the fraudulent transactions through Agbu’s company, Bonfee, and through Ibon, Inc. Ibon was another fraudulent DME supply company that shared an address with Bonfee and was owned by an alleged co-conspirator. Agbu knew that the DME claims for which he billed Medicare were frequently for PWCs that beneficiaries did not need or, at times, did not receive.
Agbu and his co-conspirators allegedly billed Medicare for more than $11 million in false claims and took in over $5.7 million as a result of the scam. After receiving the reimbursements from Medicare, Agbu laundered the money through several different bank accounts.
Agbu has pleaded guilty to one count of money laundering and one count of conspiracy to commit healthcare fraud. Agbu could receive up to twenty years in prison and a $500,000 fine.
Medicare Fraud Hurts Patients, Employees and Taxpayers
When Medicare is billed for treatment that patients didn’t need, people get hurt. The taxpayers are injured because Medicare is a healthcare program that is federally funded. Medicare is supposed to benefit the nation’s senior population — not unscrupulous health care providers. Medicare fraud also hurts employees who are pressured to participate in a fraudulent scheme or to turn a blind eye. No one should be faced with that situation.
Employee Insiders Use False Claims Act to Fight Medicare Fraud
Employee insiders are in a unique position to discover Medicare fraud and notify the government when it occurs. Sometimes health care workers are instructed to perform services they know are unnecessary. Accounting and billing personnel may be told to engage in suspicious Medicare billing practices. Doctors and nurses may see that patient records have been falsified.
To encourage health care insiders to collaborate with the government, the qui tam provisions of the False Claims Act permit a fraud informant to file a lawsuit on behalf of the government and share a portion of any money received.
Before stepping forward, tipsters should learn their rights. Our whistleblower lawyers at Waters & Kraus are prepared to offer government collaborators the skilled representation they need. Contact us or call our whistleblower lawyers at 800.226.9880 to learn more about our Medicare fraud practice and how we can assist you.