Friday, May 8, 2009

Adult Diaper Scheme Indictments

From Dale Liezon in the Houston Chronicle:
A brother and sister from Sugar Land have been accused of bilking Medicaid for more than $1 million with a scheme involving bogus claims for adult diapers.
A federal grand jury indicted Benjamin and Rose Essien on charges of conspiracy, eight counts of health care fraud and two counts aggravated identity theft for fraudulently filing claims, according to the U.S. Attorney’s Office and the state Attorney General’s Office.
U.S. Magistrate Judge Mary Milloy allowed their release Wednesday in lieu of a $50,000 bond each. The 11-count indictment, returned under seal April 30, was unsealed Tuesday.
The siblings were arrested on Wednesday.
The siblings could not be reached for comment on Thursday.
The indictment alleges that between April 2004 and August 2006, the Essiens, who owned and operated Logic World Medical, a medical equipment company in Houston, regularly billed Medicaid for adult diapers and other urinary incontinence supplies but either did not deliver them to Medicaid beneficiaries, delivered fewer diapers than were requested in claims, or provided supplies when they were not requested and physicians had not prescribed them.
The supplies included adult diapers, underpads, wipes and pull-up briefs.
The indictment alleges the siblings billed Medicaid for claims totaling $1,782,861 and received payments for those claims totaling $1,101,865.
The siblings are also accused of unlawfully using and transferring personal identification information of Medicaid beneficiaries and Medicaid participating physicians as part of their scam. Conspiracy to commit health care fraud and the health-care fraud charges carry a maximum punishment of 10 years in prison and a $250,000 fine.
Each health care fraud count carries a maximum punishment of 10 years in prison and $250,000 fine. The aggravated identity theft charges carry a mandatory two-year sentence, which must be served consecutive to any sentence imposed for the fraud charges.

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