Sunday, May 13, 2012

Detroit-Area Physician Convicted in $6.7 Million Medicare Fraud Scheme


A federal jury sitting in Detroit, Michigan convicted a Detroit-area physician for his role in a $6.7 million Medicare Fraud scheme, the Department of Justice, the FBI, and the Department of Health and Human Services (HHS) announced today.

Jonathan Agbebiyi, 62, of Sterling Heights, Michigan, was convicted of one count of conspiracy to commit health care fraud and six counts of health care fraud. Agbebiyi was a staff physician at three clinics that operated in Livonia, Michigan between 2007 and 2010: Blessed Medical Clinic, Alpha and Omega Medical Clinic, and Manuel Medical Clinic.

According to the evidence presented during the one-week trial before United States District Judge Arthur Tarnow, Jonathan Agbebiyi, an obstetrician/gynecologist, joined a conspiracy to bill Medicare for medically unnecessary neurological tests. Some of the tests involved sending an electrical current through the arms and legs of the patients. Clinic employees, who lacked any meaningful training, administered the diagnostic tests. The patients never received any follow up treatment by neurologists.

Evidence at trial showed that the patients were not referred to the clinics by their primary care physicians, or for any other legitimate purpose but, rather, were recruited with prescriptions for controlled substances, cash payments, and fast food. The three clinics then billed the Medicare program for various diagnostic tests that were medically unnecessary.

United States Attorney Barbara L. McQuade stated, “This doctor exposed patients to neurological testing solely to generate money for himself at the expense of the Medicare program. We are grateful for the hard work that uncovered this betrayal of medical ethics and theft of taxpayer funds.”

Including today’s guilty verdicts, nine individuals involved with the three clinics have been convicted for their roles in the scheme.

A sentencing date for Agbebiyi has been set for August 13, 2012. Each count of conspiracy to commit health care fraud and health care fraud carries a maximum penalty of 10 years in prison and a $250,000 fine.

Today’s verdicts were announced by Assistant Attorney General Lanny A. Breuer of the Criminal Division; U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade; Special Agent in Charge Andrew G. Arena of the FBI’s Detroit Field Office; and Special Agent in Charge Lamont Pugh, III of the HHS Office of Inspector General’s (OIG) Chicago Regional Office.

This case was prosecuted by Assistant U.S. Attorneys Frances Lee Carlson and Philip A. Ross of the Eastern District of Michigan, with assistance from Assistant Chief Gejaa T. Gobena of the Criminal Division’s Fraud Section. The case was investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan.

The Medicare Fraud Strike Force operations are part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT), a joint initiative announced in May 2009 between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country.

Since their inception in March 2007, strike force operations in nine locations have charged more than 1,330 defendants who collectively have falsely billed the Medicare program for more than $4 billion. In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

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