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Houston, Texas patient recruiter and home health agency owner was sentenced to 188 months in prison today
for her role in a $20 million scheme to pay illegal health care kickbacks to
physicians and Medicare beneficiaries in order to fraudulently bill for
medically unnecessary home health services, and to launder the proceeds. Health care fraud sentences continue to get longer. One recent case involved a lengthy sentence even though it was part of a guilty plea.
On May 29, 2019, a Houston, Texas patient recruiter Egondu "Kate" Koko was sentenced to 188 months (over 15 years) in federal prison for her role in a federal health care fraud case where she admitted she paid illegal kickbacks to physicians and Medicare beneficiaries in order to fraudulently bill for medically unnecessary home health services for four other home health agencies and her own.
The sentence came after Ms. Koko pleaded guilty in October 2018 to one count of conspiracy to pay and receive health care kickbacks and one count of conspiracy to launder monetary instruments. This sentence was lengthier than the norm since there was a money laundering count as in her plea she admitted she laundered the proceeds through another person's bank account.
The judge also ordered Ms. Koko to pay $12.9 million in restitution and to forfeit $1,378,552.00. Restitution is very high in health care kickback cases since if an illegal referral fee is paid even for medically necessary services, the entire amount billed is considered a false claim and the entire amount collected is subject to restitution. This means the loss amount is high.
As part of her guilty plea, Ms. Koko admitted to being a patient recruiter for Criseven Health Management, Beechwood Home Health, JMM Home Health and Trinity Healthcare Service, home health agencies that operated in the Houston area. Ms. Koko was also the owner and operator of Circuit Wide Home Health Services, a home health company. This type of fact would be used to show that as a Medicare provider she would know the rules barring payment for referrals.
Ms. Koko admitted that she paid illegal kickbacks and bribes to physicians and patients for paperwork necessary for Criseven, Beechwood, JMM, Trinity and Circuit Wide to bill Medicare. Ms. Koko and the other agencies submitted and were paid more than $9.5 million but less than $25 million in claims to Medicare for home health services purportedly provided by them.
Ms. Koko also admitted to committing money laundering by opening a bank account under the identity of another person who was a Nigerian national. Ms. Koko transferred proceeds from the health care fraud from accounts she controlled into the bank account of the Nigerian national. Ms. Koko also admitted that she purchased a home using the funds from the Nigerian national’s account which were proceeds from the fraud.
Attorney Commentary: By this time, one would think that home health, hospice and health care businesses would know well the peril and severe risks of using patient recruiters and paying patients or physicians. Any marketing done by health care businesses need to be vetted to ensure compliance with state and federal health care laws.
Often in cases like this, there is a pattern where patients are with one agency for a certified period and then the patient is transferred to another agency. With big data available to Medicare and the government, the patterns of the patients being rotated to different agencies can become obvious in a short time period.
On May 29, 2019, a Houston, Texas patient recruiter Egondu "Kate" Koko was sentenced to 188 months (over 15 years) in federal prison for her role in a federal health care fraud case where she admitted she paid illegal kickbacks to physicians and Medicare beneficiaries in order to fraudulently bill for medically unnecessary home health services for four other home health agencies and her own.
The sentence came after Ms. Koko pleaded guilty in October 2018 to one count of conspiracy to pay and receive health care kickbacks and one count of conspiracy to launder monetary instruments. This sentence was lengthier than the norm since there was a money laundering count as in her plea she admitted she laundered the proceeds through another person's bank account.
The judge also ordered Ms. Koko to pay $12.9 million in restitution and to forfeit $1,378,552.00. Restitution is very high in health care kickback cases since if an illegal referral fee is paid even for medically necessary services, the entire amount billed is considered a false claim and the entire amount collected is subject to restitution. This means the loss amount is high.
As part of her guilty plea, Ms. Koko admitted to being a patient recruiter for Criseven Health Management, Beechwood Home Health, JMM Home Health and Trinity Healthcare Service, home health agencies that operated in the Houston area. Ms. Koko was also the owner and operator of Circuit Wide Home Health Services, a home health company. This type of fact would be used to show that as a Medicare provider she would know the rules barring payment for referrals.
Ms. Koko admitted that she paid illegal kickbacks and bribes to physicians and patients for paperwork necessary for Criseven, Beechwood, JMM, Trinity and Circuit Wide to bill Medicare. Ms. Koko and the other agencies submitted and were paid more than $9.5 million but less than $25 million in claims to Medicare for home health services purportedly provided by them.
Ms. Koko also admitted to committing money laundering by opening a bank account under the identity of another person who was a Nigerian national. Ms. Koko transferred proceeds from the health care fraud from accounts she controlled into the bank account of the Nigerian national. Ms. Koko also admitted that she purchased a home using the funds from the Nigerian national’s account which were proceeds from the fraud.
Attorney Commentary: By this time, one would think that home health, hospice and health care businesses would know well the peril and severe risks of using patient recruiters and paying patients or physicians. Any marketing done by health care businesses need to be vetted to ensure compliance with state and federal health care laws.
Often in cases like this, there is a pattern where patients are with one agency for a certified period and then the patient is transferred to another agency. With big data available to Medicare and the government, the patterns of the patients being rotated to different agencies can become obvious in a short time period.
