News: Dallas clinicians imprisoned for role in $11 million Medicare fraud scheme

Two physicians and three nurses were sentenced last week in a $11.3 million Medicare fraud scheme involving false and fraudulent claims for home health services, the Office of Inspector General (OIG) reported.

According to the evidence presented at trial, from 2007 through 2015, the accused engaged in a scheme to defraud Medicare by submitting and causing the submission of false and fraudulent claims to Medicare, through Timely, a home health agency, and Boomer, a physician house call company.

The evidence showed that Kelly Robinett, MD, certified Medicare beneficiaries for home health services that were not provided—all while never seeing the beneficiaries himself.

Additionally, the evidence established that Joy Oguegbu, LVN, falsified nursing assessments and Kingsley Nwanguma, LVN, falsified nursing notes to make it appear as if Medicare beneficiaries were qualified for, and were provided, skilled nursing services, the OIG says.

The evidence showed that Timely billed Medicare for more than $11.3 million for home health services purportedly provided to their patients, some of which were attributable to certifications Robinett signed. Robinett’s company, Boomer, also billed Medicare over $1.6 million for medically unnecessary home health certifications and services and physician’s home visits.

Editor’s note: To read the full brief from the OIG, click here. To learn about CDI’s role in home health, click here. To read about other recent fraud and audit activity, click here.