DOCTOR SENTENCED TO PRISON FOR ROLE IN MEDICARE FRAUD

(HOUSTON, Texas) - Jayshree Patel, M.D., 63, Houston, Texas, was sentenced to 78 months in prison for her role in a far-reaching scheme to defraud Medicare of more than $21 million, United States Attorney Don DeGabrielle announced today. 

At a hearing this morning, Judge Vanessa Gilmore sentenced Patel to a 78-month prison term for each of her 10 convictions for health care fraud, with all prison terms to run concurrently.  Patel was also sentenced to three years supervised release upon the completion of her prison term and was found to be liable for restitution to Medicare in the amount of $9,477,349.

A federal jury in Houston returned the guilty verdict in October 2006, convicting Patel, Charles Frank Skripka Jr., M.D., 66, Pius James Ekiko, 44, and David Dennis Brown, 48, of health care fraud for their roles in the fraudulent scheme, which involved several tiers of illegal conduct.  Dennis Brown was previously sentenced to 80 months imprisonment, and Harold Horatio Iyalla aka “Prince Yellowe,” who cooperated with the United States and testified against the remaining co-defendants, was previously sentenced to 50 months imprisonment.  Sentencing for Ekiko is set for Oct. 22, 2007 and Skripka for Oct. 29, 2007.

The scheme involved the payment of kickbacks by Durable Medical Equipment (DME) companies to recruiters, who solicited Medicare beneficiaries to acquire motorized wheelchairs.  Recruiters referred and transported beneficiaries to physicians to secure a false or fraudulent Certificate of Medical Necessity (CMN) that DME companies would use to bill Medicare for a motorized wheelchair. 

The evidence at trial established Patel and Skripka had been hired solely to authorize motorized wheelchairs for Medicare beneficiaries who clearly did not meet the Medicare guidelines to receive such a device.  Patel and Skripka routinely approved wheelchairs for as many as 30 to 80 patients a day without performing a physical examination or ordering any medical tests.  Recruiters such as 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 Pius Ekiko’s business Horizon Medical Supply and Yellowe’s business First Choice Medical, then paid the doctor’s office $200 per fraudulent prescription and CMN and also paid Brown and other recruiters as much as $1,000 per patient in order to be able to supply the equipment to the beneficiary and thus be able to bill Medicare for that particular beneficiary.  Suppliers such as Ekiko would then use the fraudulent prescription and CMN to bill Medicare for a motorized wheelchair, but would instead deliver the significantly less expensive scooter to the beneficiary.  Medicare paid suppliers approximately $4,200 per wheelchair, while the scooters that were actually provided were only paid at a rate of $1600 per scooter.

The evidence at trial showed that Patel falsely certified in excess of 1,900 Medicare beneficiaries for a motorized wheelchair.  

The criminal conviction is the result of a joint investigation conducted by agents of the U.S. Department of Health and Human Services - Office of Inspector General, FBI and the Texas Attorney General’s Medicaid Fraud Control Unit.  The case was prosecuted by Assistant United States Attorneys Al Balboni and Jason Varnado.

 

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