Two More DME Operators Indicted in Health Care Fraud Case

June 24, 2010 - HOUSTON—Bassey Essien and Ebong Akpan, of Houston, have been charged by a federal grand jury with conspiracy, multiple counts of health care fraud, and aggravated identity theft for their roles in a scheme to defraud Medicaid through the fraudulent billing for adult urinary incontinence supplies, United States Attorney José Angel Moreno and Texas Attorney General Greg Abbott announced today.

A federal grand jury returned a superseding indictment on June 3, 2010, adding Essien, 60, and Akpan 35, as defendants in a previously charged health care fraud scheme allegedly involving the operation of Logic World Medical and Roben Medical, both durable medical equipment (DME) companies located in Houston. According to allegations in the indictment, Essien and Akpan unlawfully received Medicaid beneficiaries’ information, including names, addresses and Medicaid numbers, which they used to file false claims through these DME companies for adult incontinence supplies, including adult diapers, underpads, wipes, and pull-up briefs. The first indictment charged Benjamin Essien, 34, and Rose Essien, 29—Bassey Essien’s son and daughter.

Bassey Essien and Akpang were taken into custody this morning by investigating agents, have appeared before a U.S. Magistrate and been ordered released upon posting a $50,000 bond. In addition to the bond amount the court has ordered, while on pretrial release, each defendant must surrender their Nigerian passports and are prohibited from being involved in any businesses which bills Medicare or Medicaid for services or supplies.

Bassey Essien and Akpan are accused of routinely billing Medicaid for adult urinary incontinence supplies they allegedly did not deliver to the Medicaid beneficiaries, or for delivering supplies in amounts significantly less than the amounts billed to Medicaid or for supplies provided to Medicaid beneficiaries who either did not need or whose physicians had not prescribed the supplies. According to the indictment, Bassey Essien and Akpan continued to bill Medicaid for incontinence supplies even after their delivery staff and/or delivery contractors were told by the beneficiaries they did not need or want the supplies. Moreover, each is accused of billing Medicaid the maximum allowed amount of incontinence supplies each month per beneficiary, for extra large size diaper briefs, which have the highest Medicaid reimbursement rate, without consideration to the actual size needed by a beneficiary and even billing Medicaid for delivering a quantity of adult diapers far in excess of the amount they purchased from wholesale suppliers.

The scheme to defraud is alleged to have begun in April 2004, through Logic World, with the last allegedly false claim having been filed in February 2010 through Roben Medical. During this time period, Essien and Akpan allegedly billed and caused the billing of Medicaid for claims totaling approximately $2,341,293.64 and received payments for those claims totaling approximately $1,455,837.91.

Bassey Essien, Akpan and Rose Essien, all of whom are presumed innocent unless and until convicted through due process of law, are pending trial on the charges. All defendants face a maximum of 10 years’ imprisonment and a $250,000 fine, if convicted of conspiracy or any of the healthcare fraud counts in which they are accused in addition to a mandatory two-year consecutive term of imprisonment for aggravated identity theft. Benjamin Essien, 34, has pleaded guilty to conspiracy to commit health care fraud, health care fraud and aggravated identity theft and is pending sentencing in August 2010.

This case was the result of the investigative efforts of the Health and Human Services Office of the Inspector General, the Texas Attorney General’s Medicaid Fraud Unit in Houston and the FBI. Special Assistant United States Attorney Justo A. Méndez and Assistant United States Attorney Al Balboni are prosecuting the case.