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Home Health Agency Owner Pleads Guilty to Conspiring in $17 Million Medicaid Fraud Scheme

Posted  March 31, 2017

By the C|C Whistleblower Lawyer Team

The owner and operator of five Houston-area home health agencies pleaded guilty to conspiring to defraud Medicare and the State of Texas’s Medicaid-funded Home and Community-Based Service and Primary Home Care programs of more than $17 million.  He also pleaded guilty to conspiring to launder money.  These health care programs provided qualified individuals with in-home attendant and community-based services that are known commonly as “provider attendant services.”  This case marks the largest PAS fraud case charged in Texas history.

Godwin Oriakhi pleaded guilty to two counts of conspiracy to commit health care fraud and one count of money laundering.   According to his plea, Oriakhi admitted that he and other members of his family obtained patients for his home health agencies by paying illegal kickback payments to patient recruiters and his office employees for hundreds of patient referrals. Oriakhi also admitted that he paid Medicare and Medicaid patients by cash, check, Western Union and Moneygram for receiving services from his family’s home health agencies in exchange for the ability to use their Medicare and Medicaid numbers to bill the programs for home healthcare and PAS services.

Additionally, Oriakhi admitted that paid physicians illegal kickbacks payments, which Oriakhi and his co-conspirators called “copayments,” for referring and certifying Medicare and Medicaid patients for home health and PAS services and that each time he submitted a claim predicated on an illegal kickback payment he knew he was submitting a fraudulent claim to Medicare or Medicaid.  In addition to the home healthcare and PAS services fraud scheme, Oriakhi admitted that he used the money fraudulently obtained from Medicare and Medicaid to pay illegal kickback payments to patient recruiters, employees, physicians and patients to promote the Medicare home health and Medicaid PAS fraud conspiracies, and ensure their successful continuation.

In total, Oriakhi admitted that he and his family submitted approximately $17,212,051 in fraudulent home healthcare and PAS claims to Medicare and Medicaid and received approximately $16,198,600 on those claims. DOJ

Tagged in: Anti-Kickback and Stark, FCA State, Home Health and Hospice, Medicaid,