TWO HOUSTON DOCTORS AMONG FOUR CONVICTED OF DEFRAUDING MEDICARE OF TWENTY-ONE MILLION DOLLARS

HOUSTON, TX – Four individuals, including two local doctors, were convicted of multiple counts of defrauding Medicare in what has become known as the "motorized wheelchair fraud scheme,” announced United States Attorney Don DeGabrielle.

A federal jury in Houston returned the guilty verdict late Friday, October 13, 2006, convicting Charles Frank Skripka, Jr., M.D., 65, Jayshree Patel, M.D., 62, Pius James Ekiko, 43, and David Dennis Brown, 47, of health care fraud for their roles in a far-reaching scheme to defraud Medicare of more than $21 million. Skripka, Ekiko and Brown were also convicted of conspiracy to defraud Medicare and wire fraud, and Skripka and Ekiko were convicted of several counts of money laundering.

The scheme involved several tiers: 1) the payment of kickbacks by Durable Medical Equipment (DME) companies to recruiters who solicit Medicare beneficiaries to be evaluated by complicit doctors; 2) the referral and transport of beneficiaries by the recruiters to those physicians to secure a false or fraudulent Certificate of Medical Necessity (CMN) required to bill Medicare for a motorized wheelchair; 3) the use of the fraudulent CMNs by DME company owners to bill Medicare for the medically unnecessary wheelchairs, and the delivery of a scooter instead to the beneficiary.

The evidence established that Doctors Skripka and Patel had been hired solely to authorize motorized wheelchairs for Medicare beneficiaries who clearly did not meet the Medicare guidelines to receive such a device. Skripka and Patel routinely approved wheelchairs for as many as 30 to 80 patients a day without performing a physical examination or ordering any medical tests.

The evidence presented at trial proved that Doctors Skripka and Patel fraudulently certified physically fit Medicare beneficiaries for motorized wheelchairs. Recruiters, like Dennis Brown, recruited Medicare beneficiaries with the promise of free scooters and the payment of $50 to see Doctors Patel and Skripka. Brown recruited patients from Louisiana and transported them 350 miles to Houston to see the physicians. DME companies, such as Horizon Medical Supply, which was owned by Pius Ekiko, then paid the doctor’s office $200 per fraudulent prescription and CMN. Ekiko used the fraudulent CMN to bill for a motorized wheelchair even though he provided a significantly less expensive scooter to the beneficiary. Medicare paid Ekiko approximately $4,200 per wheelchair. Medicare only pays approximately $1,600 for a scooter.

Sentencing is set for January 17, 2007. Each of the health care fraud counts carries a maximum penalty of 10 years in a federal prison, without parole, and a $250,000 fine. Each of the wire fraud counts carries a maximum penalty of five (5) years of imprisonment and a $250,000 fine. The conspiracy carries a penalty of five (5) years of imprisonment and a $250,000 fine. The money laundering counts carry either a 10 or 20 year maximum penalty and as much as a $500,000 fine.

The criminal charges are the result of a joint investigation conducted by agents of the U.S. Department of Health and Human Services, Office of Inspector General and the Federal Bureau of Investigation. The case was prosecuted by Assistant United States Attorney Al Balboni and Special Assistant United States Attorney Jason Varnado.