Medical supplier sentenced for wheelchair scam

Released by the U.S. Attorney's Office in the Eastern District of Texas:

BEAUMONT, Texas — U.S. Attorney John M. Bales announced that the owner of a medical supply business has been sentenced to federal prison for federal health care fraud violations in the Eastern District of Texas.

ENITAN OSAGIE ISIWELE, 44, of Sugarland, Texas, was convicted by a jury on Mar. 19, 2009, of 16 counts of health care fraud and one count of conspiracy to pay illegal kickbacks and was sentenced to 97 months in federal prison on Apr. 9, 2010 by U.S. District Judge Marcia Crone.  Isiwele was also ordered to pay restitution in the amount of $201,000.

According to information presented in court, Isiwele owned and operated Galaxy Medical Supplies, a medical equipment provider, based in Houston, Texas, but with customers throughout the state, including many in the Eastern District of Texas.  From June 2005 until April 2008, Isiwele purchased Medicaid and Medicare patient information from door-to-door solicitors who canvassed neighborhoods in search of Medicare or Medicaid beneficiaries.  Isiwele then used this information to bill Medicaid and Medicare for motorized wheelchairs when the patients did not meet the diagnostic requirements to receive a motorized wheelchair and had never been prescribed one by a physician, as required by Medicare and Medicaid rules.

On at least one occasion, Isiwele contacted a Medicare recipient in Crockett, Texas and told him he had won a free power wheelchair, and that he would be by to deliver it.  That recipient, along with all the others who appeared in court, testified he was never prescribed a power wheelchair by a physician.

In order to circumvent Medicare and Medicaid diagnostic requirements, Isiwele took advantage of a temporary relaxation of the normal safeguards.  In the wake of hurricanes Katrina and Rita, in an effort to expedite aid to those affected, Medicare allowed providers to submit claims without prescriptions and other required paperwork if the beneficiary reported that their previously prescribed equipment or supplies had been destroyed by a hurricane.  In total, Isiwele fraudulently over-billed Medicare and Medicaid approximately $587,000.  Isiwele was indicted by a federal grand jury on December 3, 2008.

The case was investigated by the Texas Attorney General's Office Medicaid Fraud Control Unit and the Health and Human Services - Office of Inspector General and was prosecuted by Assistant U.S. Attorney Christopher Tortorice and Special Assistant U.S. Attorney Howard Blackmon.