By Kay B. Day | Watchdog Arena
The FBI’s Most Wanted list is iconic—the subject of films, TV series, and docudramas. But there’s another Most Wanted list unknown to most Americans.
Did you know the Office of Inspector General at the US Dept. of Health and Human Services has a Most Wanted list? Individuals on the list were either convicted of or charged with crimes such as money laundering, filing fraudulent medical claims, overcharging or not providing services they charged the government for, and even posing as legitimate health care workers in order to steal information about vulnerable patients who needed critical wound care.
The individuals on the list operated in numerous states, including Rhode Island, Michigan, New York, Ohio, Kentucky, and Florida. Most fled to foreign countries once their deeds were uncovered. Some fled after they were convicted; others fled after bail was set and they faced trial.
One man even managed to escape the United States after he was convicted and was awaiting sentencing. His monitoring device alerted authorities. By the time they got to his home, he had fled by plane from Miami to the Dominican Republic.
The HHS OIG website features an overview of each individual, and even a cursory glance at each entry suggests that federal coffers are ripe for plundering.
One current fugitive is a fake doctor. The OIG said Ezechukwu “Dr. Joshua” Ohaka was no doctor, but he was adept at manipulating the Medicare program for durable medical equipment. A federal indictment stated the “gross proceeds of the fraud allegedly totaled approximately $1.08 million.”
The fake doc was based in Houston. He and others in his service were indicted on charges related to billing Medicare for wheelchairs, scooters, and wheelchair accessories. The items weren’t even necessary, and some of them were never provided to patients.
The recipients of the items hadn’t even been to a doctor. They had no prescription, a requirement for Medicare reimbursement. The group targeted people who had been impacted by Hurricanes Katrina and Rita. Ohaka was originally from Nigeria. His whereabouts are unknown.
In Florida, Luciano Velazquez is believed to have gleaned approximately $2.9 million by ripping off Medicare. He was indicted on charges of health care fraud, false statements related to health care fraud matters, and aggravated identity theft.
Using fake companies, Velazquez billed Medicare more than $8 million in false claims. The victims he allegedly targeted needed HIV infusion and cancer drug therapies. The government managed to recover a paltry $175,000 before Velazquez took off for parts unknown.
In Michigan, after authorities questioned Shafiulla Abdul Hanif, he and his cohorts fled after submitting more than $18 million in fraudulent claims to Medicare for treatments and services that either weren’t delivered or were medically unnecessary.
His companies allegedly hired both licensed and unlicensed therapists to provide physical and occupational therapy to patients. The group paid Medicare enrollees to sign forms based on fraudulent information. Some of his co-conspirators were tried and sentenced to prison, with an order to pay more than $9.7 million in restitution. Is it likely taxpayers will see any of that money repaid?
In New York, Etienne Allonce and his wife Helene Michel were indicted, accused among other things of enlisting people to pose as subcontractors for a legitimate surgical supply company. These fake subcontractors entered nursing homes under false pretenses, and allegedly accessed medical charts for patients who needed specialized wound care.
Allonce and his group then allegedly billed both Medicare and Medicaid for care and supplies that didn’t exist. Allonce is believed to be in Haiti. His wife was convicted of health care fraud and wrongful disclosure of identifiable health information, and she was sentenced to 12 years in prison. She was also ordered to repay more than $4 million, but whether that is likely no one knows.
The HHS OIG Most Wanted list is replete with individuals who seize opportunity because of the inability of the federal bureaucracy to safeguard taxpayer money. Countries where these scammers or suspected scammers have fled include Pakistan, Haiti, Sudan, Mexico, Colombia, Dominican Republic, Cuba, Iraq and elsewhere. Countries of origin are not given for all the culprits, including Shafiulla Abdul Hanif.
Apparently there’s not a no-fly list for criminals like those on the HHS OIG Most Wanted list.
The reports on each case involving Medicare and Medicaid fraud represent a pittance of what these programs lose each year to criminals who vaporize hard-earned tax dollars for personal gain. The Centers for Medicare and Medicaid Services published a report in 2014, setting the amount of tax dollars paid for 50 million Medicare “beneficiaries” at $566 billion.
The CMS report also said, “Medicaid processes 3.9 billion claims, representing more than $430 billion annually.”
Medicaid expenditures will increase because of the Patient Protection and Affordable Care Act, commonly called Obamacare.
It’s a given that would-be fraudsters know this, and are making plans to line their pockets with dollars that come easy to the federal government, but not to the taxpayers, both individual and corporate, who fund the programs.
Merrill Matthews, a scholar for the Institute for Policy Innovation in Dallas (Texas) wrote about a Government Accountability Office report about Medicare and Medicaid released in 2010. That report, wrote Matthews at Forbes, “identified $48 billion in what it termed as ‘improper payments.’”
In 2012, the US Dept. of Justice and the Dept. of Human Services announced via the Medicare Strike Force that fraud schemes in Medicare billing totaled more than $400 million. The Strike Force was created under the administration of President George W. Bush.
Actual fraud is likely higher because the government cannot document all the fraud. As Matthews noted, “No one knows for sure.”
The reports on individuals on the HHS OIG Most Wanted page read like dime novels. Perhaps Americans will one day see a Most Wanted series for such white collar fraud on TV, in the tradition of the docudramas recounting violent crimes.
This article was written by a contributor of Watchdog Arena, Franklin Center’s network of writers, bloggers, and citizen journalists.