Tuesday, August 21, 2012

Houston Doctor Arrested on Charges of Health Care Fraud

Dr. Emmanuel Nwora, 48, of Houston, has been arrested following the return of a sealed indictment alleging health care fraud and conspiracy to commit health care fraud, United States Attorney Kenneth Magidson announced.
The 13-count indictment was unsealed just moments ago upon Nwora’s arrest by agents with FBI, the Texas Attorney General’s Medicaid Fraud Control Unit, and Department of Health and Human Services-Office of Inspector General, Office of Investigations. He is expected to appear before U.S. Magistrate Judge Nancy Johnson. Also charged is Charles Harris, 52, aka Celestine Nwajfor and Okechi Nwajfor, also of Houston. Harris (photo below) is currently a fugitive and a warrant remains outstanding for his arrest. Anyone with information about his whereabouts is asked to contact the FBI at 713-693-5000.

The indictment alleges that from 2007 to 2010, Nwora and Harris falsely billed Medicare and Medicaid under vestibular diagnostic codes. They allegedly billed Medicare and Medicaid approximately $850,000 and were paid approximately $390,000. Vestibular problems are traditionally inner ear problems with the patients reporting chronic dizziness and balance problems.
Nwora operated a family practice clinic in Houston called Houston Optimum Care Medical Association, while Harris operated a Houston business called Cevine Health Care and Rehabilitation Center. According to the indictment, Harris would send unlicensed persons into Medicare beneficiaries homes to perform some types of vestibular testing. Harris allegedly would then submit “superbills” to Nwora and his billing contractor for this testing. The indictment indicates that patients reported either that none of the testing was performed or that some form of testing was performed but not in the quantity that was actually billed. One patient’s Medicare number was allegedly billed for more than 800 tests on 161 different days over the course of one year. Others were billed for more than 500 tests over a period of one year, according to the indictment. The patients, their families or their treating doctors reported that these patients did not need vestibular testing and did not complain of dizziness.

Nwora allegedly billed Medicare and Medicaid for these diagnostic tests and split the paid claims with Harris. The indictment indicates that Nwora kept 35 percent, while Harris received the remainder.

Each of the 13 counts in the indictment carry as possible punishment up to 10 years in federal prison and a possible $250,000 fine.

The charges are the result of the investigative efforts of the Department of Health and Human Services-Office of Inspector General, Office of Investigations as well as the Texas Attorney General’s Medicaid Fraud Control Unit, FBI, and the United States Attorney’s Office. Special Assistant United States Attorney Suzanne Bradley is prosecuting the case.

An indictment is a formal accusation of criminal conduct, not evidence. A defendant is presumed innocent unless and until convicted through due process of law.

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