In summer 2009, a Woodbridge health care agency billed Virginia Medicaid administrators more than $1,000 for care it said it provided to a patient, saying it cared for him for 76 hours between June 15 and July 12.
The problem, according to federal prosecutors, is that the patient, referred to as Burton H., died on May 31.
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Now, two employees at First Call Home Health are facing accusations that they bilked taxpayers out of more than $1 million by filing false claims, like those in Burton H.’s case.
Owner and registered nurse Godwin Ikwuamkam and office manager Yannick Pierre have been charged with health care fraud in federal court in Alexandria.
No working phone number could be located for First Call, Ikwuamkam or Pierre. No attorneys were listed in court records for Ikwuakam or Pierre.
First Call provided personal care, respite care and in-home nursing services. A criminal complaint says that Ikwuamkam and Pierre submitted hundreds of fraudulent claims, totaling $1,049,237, between January 2008 and June 2010.
In one case, the complaint says, First Call billed the state’s Medicaid administrators for $1,269 in respite care services over 86 hours in April 2009 for patient Veronica P., but actually provided no patient care.
In another case, the health care provider billed for 496 hours of care for a patient named Kathleen C. by a registered nurse, when care had been provided for just 197 hours, according to the complaint.
First Call also sought reimbursement for care provided by a registered nurse, rather than a licensed practical nurse, in order to get more money, even when a licensed practical nurse cared for the patient, the complaint alleges.
The investigation into the practice began after a department audit in January 2010 found that billing records didn’t match receipts, signatures of caregivers and nurses were often missing on documents and other problems. Prince William County authorities have also investigated the pair for Medicaid fraud.
In a May 2010 interview, Pierre told an FBI agent that “billing was never done the way it was supposed to be done,” the complaint says. Other staff members told investigators that they were told to clean up charts by creating supporting evidence for bills First Call had filed.
