DME OWNER PLEADS GUILTY IN WHEELCHAIR SCAM

HOUSTON, TX – The owner of Makey Medical Sales and Supplies, a durable medical supply company in Sugarland, Texas, was convicted today of conspiracy and health care fraud as a result of an ongoing investigation into what has become knows as a “wheelchair scam,” United States Attorney Don DeGabrielle announced today.

At a hearing this afternoon before United States District Judge Keith Ellison, Anthony Ekpe Etim, 54, of Sugar Land, pleaded guilty to one count of conspiracy to defraud the United States and one count of health care fraud. Etim faces a maximum sentence of five years in federal prison for the conspiracy conviction and 10 years in prison for the health care fraud conviction at his sentencing, which has been set for January 12, 2007.

Etim, who has been free on a $100,000 bond since his arrest in April 2006, has been permitted to remain free on bond pending his sentencing.

Etim, the sole owner of a company called Makey Medical Sales and Supplies, was convicted of fraudulently billing Medicare in excess of $1.5 million between June 2000 and December 2002 for durable medical equipment, primarily expensive motorized wheelchairs and related accessories, but actually delivering a less expensive scooter to Medicare patient-beneficiaries. During the time of the conspiracy, a motorized wheelchair and its accessories were reimbursed by Medicare at a rate of approximately $7,000; a scooter costs substantially less – approximately $800-1,200 wholesale.

The evidence proffered by the United States proved that during the course of the conspiracy, Etim filed approximately 267 claims with Medicare, of which approximately 255 were for motorized wheelchairs and their accessories for Medicare beneficiaries. In order to qualify for a motorized wheelchair, Medicare requires that a patient have no upper body strength to operate a manual wheelchair. To bill Medicare for this type of equipment, a claim must be accompanied by a physician’s prescription and a Certificate of Medical Necessity (CMN) certifying the beneficiaries’ medical need for the equipment. Etim purchased the prescriptions and CMNs from marketers who had obtained them from Dr. Anant Mauskar and Dr. Lewis Gottlieb. Approximately 212 of the claims filed by Etim used Dr. Lewis Gottlieb’s Universal Physician Identification Number (UPIN). Another 43 were filed using Dr. Anant Mauskar’s UPIN. Both physicians have been convicted of signing prescriptions for motorized wheelchairs for Medicare beneficiaries who did not meet the medical necessity requirements to receive a motorized wheelchair.

All of Etim’s wheelchair claims filed with Medicare by and through his DME company were fraudulent because he billed for the more expensive motorized wheelchair, but delivered the less expensive scooter.

In all, Makey Medical billed Medicare for more than $1.5 million, of which more than $1.0 million was paid.

Dr. Anant Mauskar was convicted by a jury’s verdict of health care fraud and was sentenced to 135 months in federal prison on June 16, 2006.

Dr. Gottlieb has pleaded guilty to signing prescriptions for patients who did not meet the medical necessity requirements to receive a motorized wheelchair. He is pending sentencing.

The charges against Etim are the result of an investigation conducted by the Federal Bureau of Investigation, the Texas Attorney General’s Medicaid Fraud Unit in Houston; Health and Human Services Office of the Inspector General, Office of Investigations; and the U.S. Attorney’s Office. Special Assistant United States Attorney Suzanne Bradley is prosecuting the case.