HOUSTON – Federal prosecutors say tens of millions of taxpayer dollars are wasted each year on fraudulent Medicare and Medicaid payments made to health care professionals.
"Taxpayers really should be frustrated," federal prosecutor Jennifer Lowery said. Lowery is the chief deputy of program fraud at the U.S. Attorney's Office in Houston. "You don't ever get all of the money back."
In April, a judge sentenced Yolanda Nowlin, of Bryan, to federal prison for 11 years after she was convicted of health care fraud conspiracy.
Nowlin ran two medical-equipment supply companies and submitted claims to Medicare and Medicaid for equipment that wasn't delivered.
In one case, a severely disabled woman who needed an expensive, specialized wheelchair was given a traditional wheelchair even though Nowlin billed Medicaid for the more expensive one.
"She was providing (patients) with something cheap and billing for something expensive so she got a higher reimbursement," federal prosecutor Adrienne Frazior told Local 2 Investigative Reporter Jace Larson.
Umawa Oke Imo was convicted in 2011 of stealing $30 million. He operated the now-closed City Nursing. At his trial, employees testified about how City Nursing billed Medicare for treatment that was not provided, including treatment for numerous people who were dead when the treatment supposedly took place.
Oke paid people who received Medicare to come to his office and sign blank treatment forms indicating they received physical therapy.
"There was no physical therapist. Nobody was doing any physical therapy," federal prosecutor Julie Redlinger told Local 2. "One lady testified she was on the train. She got asked if she wanted to make some money and if she had a Medicare card. Another lady testified that a man came by her house and asked if she wanted to make some money to go see a doctor."
Local 2 found the former City Nursing office on Bissonnet in Southwest Houston unlocked. The office appeared trashed. A few patient files were on the floor along with several documents with City Nursing's header.
Oke received 27 years in prison.
A husband-and-wife team of doctors raked in $62 million when they billed Medicare, Medicaid and private insurance companies for pain injections that didn't really take place.
Drs. Kiran and Arun Sharma also received prison sentences.
"He was known in the community as a pill doctor," federal prosecutor Al Balboni said.
They gave superficial injections to patients, but they falsely billed for major joint and spinal injections.
"He was never doing what he was claiming," Balboni said.
He said during the time of the scheme, the Sharmas' practice increased the number of patients it claimed to see. In 1998, they saw an average of 50-60 patients a day.
That jumped to more than 100 a day in 2003, Balboni told Local 2.
On Jan. 6, 2005, the Sharma practice claimed it saw 279 patients.
Balboni said it is impossible for a doctor to give major injections to that may people in one day.
Asset forfeiture:
Prosecutors go after lost taxpayer money, but rarely recover all of it.
"Sometimes the money goes to another country and we cannot get it. But we follow their bank accounts and see what assets they have, and use forfeiture laws to try and get the property back," said Balboni.
In the Sharma case, investigators found $700,000 in cash inside their luxury, waterfront Kemah home and $800,000 in two safety deposit boxes.
The government seized and sold their $700,000 home in Kemah.
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