A 59-year-old Sugar Land, Texas man has admitted to conspiring to commit health care fraud through Medicare ambulance claims, announced U.S. Attorney Ryan K. Patrick.
Anthony Chukwudi Nwosah is the owner of Tonieann EMS and Rosenberg EMS. On Monday, August 20, 2018, he admitted he conspired to submit more than $3 million in false and fraudulent claims to Medicare for ambulance transport services that were not provided and not medically necessary. Nwosah received approximately $1,094,260 as payment for those claims.
Nwosah admitted he submitted the ambulance claims for Medicare beneficiaries transported by vans, not ambulances, to routine psychotherapy appointments and for at least one other beneficiary who did not require ambulance transportation. Nwosah also admitted he instructed a licensed emergency medical technician (EMT) to create fake ambulance transport records which included fake vital signs, patient narratives and transport mileage. Additionally, he admitted that more than 2,000 fake ambulance transport records contained the name of another EMT who never worked for him.
The Medicare program requires ambulance providers to sign an enrollment application that expressly states the provider will not knowingly submit false or fraudulent claims to Medicare or claims with deliberate ignorance or reckless disregard for their truth or falsity. The Medicare program only intended to pay for ambulance services that were provided and medically necessary. Medicare did not intend to pay for ambulance services provided by vans or taxis or for beneficiaries who, at the time of transportation, could safely be transported by other means.
U.S. District Judge Lynn Hughes accepted the plea and has set sentencing for Nov. 19, 2018. At that time, Nwosah faces up to 10 years in federal prison and a $250,000 fine.
He was permitted to remain on bond pending that hearing.
The Department of Health and Human Services – Office of the Inspector General and the FBI conducted the investigation. Assistant U.S. Attorney Julie Redlinger prosecuted the case.
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