Medical Equipment Medicaid Fraud: Wheelchair rip-off
A man has pled guilty to charging Medicaid for expensive power wheelchairs while actually providing cheap, basic wheelchairs to recipients. Charging the government for more expensive medical equipment than actually provided is a common form of Medicaid Fraud called up-coding. The man, Uche Ben Odunzeh, also billed Medicaid for medical supplies he never even provided. Odunzeh, the owner of Empire Medical Services, submitted false claims to the government amounting to more than $275,000.
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As detailed by the U.S. Attorney’s Office for the District of Columbia,
From on or about January 8, 2008, through on or about March 18, 2011, Emerald Medical submitted 100 claims to the District of Columbia’s Medicaid program for power wheelchairs, totaling $591,653. The D.C. Medicaid program paid Emerald approximately $480,272 for those claims. All of those claims were for the most expensive power wheelchair, referred to by its procedural billing code of K0011. In fact, however, Emerald Medical provided only more basic, less expensive wheelchairs. The D.C. Medicaid program paid Emerald Medical approximately $6,157 per K0011 chair – nearly twice as much as it would have paid for the less sophisticated chairs that Emerald Medical actually provided. Odunzeh admitted that the program paid Emerald Medical about $232,470 more than what the company was entitled to receive.
During the same time period, Emerald Medical also submitted numerous claims to the D.C. Medicaid program for DME items that it never provided to Medicaid recipients. For example, the D.C. Medicaid program paid Emerald Medical about $44,913 for adult incontinence supplies such as diapers, disposable underpads and gloves that were never actually provided.
Odunzeh’s fraud falls into two of the most common types of Medicare and Medicaid fraud:
- Over-billing for services, drugs, or devices. Examples: billing for higher CPT procedure codes than were performed, or unbundling services into their individual parts to get paid more by Medicare or Medicaid
- Billing for services, drugs, or devices that are not medically necessary or were never even provided