Husband & Wife Received Over $1.6m from Fraudulent Payments

SAN FRANCISCO: Three defendants including a married couple have been convicted in a $3.2 million Medicare fraud scheme.  

Husband and wife - Patrick Adebowale Sogbein and Adebola Adefunke Adebimpe were convicted together with Eduardo Abad of health care fraud and conspiracy to commit health care fraud by a federal jury.


Both Sogbein and Abad were also convicted of conspiracy to pay and receive kickbacks involving the Medicare program. And in total Sogbein and Adebimpe were paid more than $1.6 million by Medicare.

Jury findings
Following a 13 day trial, the jury found that between dates in 2006 and 2011, Sogbein and Adebimpe submitted more than $3.2 million in fraudulent claims to Medicare through two different medical equipment companies in the Loss Angeles area. Medicare beneficiaries for these prescriptions had been purposely identified by Abad and other street-level recruiters. 

The jury also found that Sogbein had paid and Abad had received cash kickbacks in exchange for the referral of the Medicare beneficiaries. 

Co-defendents
Prior to trial, on September 30, 2013 and October 21, 2013, respectively, co-defendants Edna Calaustro and Mele Saavedra, both from San Francisco, pleaded guilty to conspiracy to commit health care fraud, conspiracy to receive kickbacks involving Medicare and health care fraud.

Sogbein and Adebimpe were remanded into custody following conviction  while Abad, Calaustro, and Saavedra remain out of custody.

Evidence
According to evidence Sogbein who is the owner of Debs Medical Distributors began working with Calaustro who works as a physician, to obtain bogus prescriptions for power wheelchairs.

In 2008  Sogbein was experiencing increasing difficulties when Medicare started scrutinizing some of his submitted claims, so he started to submit claims through a separate company in his wife's name - Dignity Medical Supply in Santa Clarita.

Sogbein and Calaustro then worked with Abad, Saavedra, and others to identify Medicare beneficiaries. 

Beneficiaries were recruited by the team in locations in the San Francisco neighborhoods of Tenderloin and South of Market and includa fast food restaurant at the Powell Street cable car turnaround and a Tenderloin neighborhood senior center. 

Sham examinations 
One of the convicted would then travel to the beneficiaries’ homes with a portable copy machine where they copied their Medicare cards, and conducted sham examinations to obtain background information for the required Medicare paperwork. Calaustro would then give the fraudulent paperwork and bogus prescriptions to Sogbein and Adebimpe. 

In turn, additional fraudulent paperwork would be created in the names of their respective companies and submit these to Medicare. 

Payments
Sogbein paid Calaustro $100 for each power wheelchair prescription. Sogbein paid Abad and Saavedra $100 and $50, respectively, for each beneficiary they identified. It's understood that over the five-year period, Sogbein and Adebimpe billed Medicare for over 400 power wheelchairs using the bogus prescriptions.

Comment 
“Health care fraud is particularly pernicious because it not only defrauds the government, but it inhibits Medicare’s ability to help those in need," said United States attorney Melinda Haag. 

"The verdict reaffirms this office’s commitment to prosecuting those who intentionally engage in schemes to defraud Medicare,” Haag added.

Special Agent in Charge David J. Johnson noted that the result of this case represented the FBI’s commitment to aggressively identify and investigating health care fraud crimes. 

“Our outstanding partnership with HHS-OIG nationwide allowed us to successfully work with their office in Los Angeles in order to bring down this egregious health care fraud scheme operating throughout California.”

Sentencing hearing
A sentencing hearing for Sogbein, Adebimpe, and Abad is now scheduled for March 20, 2014.

The maximum statutory penalty for each count of conspiracy to engage in health care fraud is 10 years imprisonment and a fine of $250,000, or twice the amount gained in the course of the fraud (whichever is greater).

The maximum statutory penalty for conspiracy to pay and receive kickbacks involving the Medicare program is five years’ imprisonment, and a fine of $250,000. 

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