Source: US FBI
HOUSTON – A 64-year-old man has been convicted of all counts as charged for leading a Medicare fraud scheme involving the submission of falsified medical records, announced U.S. Attorney Nicholas J. Ganjei.
The jury deliberated for less than two hours before convicting Paul Njoku following a three-day trial.
Njoku owned and operated a home health care agency called Opnet Health Care Services Inc. doing business as P & P Health Care Services. Njoku was the owner and CEO.
The jury heard testimony from witnesses that Njoku, or others working at his direction, forged signatures of doctors and nurses. Specifically, Njoku and others cut out old signatures and taped them onto newly created doctors’ orders, nursing notes and nursing assessments. Medicare required home health agencies to maintain these documents to obtain payment for providing home health services. Njoku then submitted the falsified records in response to a request for records from Medicare.
The jury also heard about a registered nurse who had departed Opnet in 2017. Njoku continued using her signature on nursing notes and assessments in 2018 and 2019 without her knowledge or consent.
A witness also testified that Njoku bribed a doctor in exchange for approving home health services.
From 2015 to 2019, Opnet billed Medicare over $400,000 in claims for home health services and received over $360,000. Opnet did not maintain the required documentation for many of them and later falsified records to support the claims.
During the trial, a representative testified that Medicare would not have paid these claims had Medicare known there was no documentation or that they were based on falsified records.
“It is absolutely paramount that Americans—both as patients and as taxpayers—have confidence in the integrity of medical providers that receive Medicare funds. Here, the defendant unrepentantly abused that trust by engaging in bribery and stealing from Medicare,” said Ganjei. “With today’s guilty verdict, the Southern District of Texas aims to restore some of that lost trust. I thank the jury for their time and attention to this important case.”
The defense attempted to blame another person for the fraud. The jury did not believe those claims and found him guilty as charged.
U.S. District Judge Alfred H. Bennett presided over the trial and will set sentencing at a later date. At that time, Njoku will face a maximum of 10 years for conspiracy to commit health care fraud, five years for two counts of false statements relating to health care matters as well as another two years for the identity theft which must be served consecutively to any other prison term imposed. The convictions also carry a possible $250,000 fine for each count.
He was permitted to remain on bond pending sentencing.
The FBI, Department of Health and Human Services-Office of the Inspector General and Texas Attorney General’s Medicaid Fraud Control Unit conducted the investigation. Assistant U.S. Attorneys Christian Latham and Kathryn Olson are prosecuting the case.