HOUSTON—The dollar amounts are staggering: allegations that people who live in some of Houston’s finest neighborhoods owe some of their wealth to bilking the federal Medicare and Medicaid programs out of tens of millions of dollars.
"What was off the charts was Miami, Los Angeles and Houston," said James Buchanan, who heads up the white-collar fraud unit at the U.S. Attorney’s Office in Houston.
Houston was one of the first three cities targeted by a special federal strike team that arrested 34 people locally and is now in the process of prosecuting or negotiating deals with them.
"These are people the neighbors say, ‘Well, they seemed so nice, they were always so generous.’ Well, of course they were, they were stealing our money," said Patricia Gray, a former Texas State Representative and current health law expert at the University of Houston Law Center.
The accused were people running store-front clinics, billing Medicaid and Medicare for treatment that was never given, or for medical equipment that was never actually used, according to the indictments.
They lived in some of the area’s finest neighborhoods, including a doctor in a million-dollar home in West University Place and an international businessman who lived in an upscale home in the Cinco Ranch development in Fort Bend County.
The businessman, Umawa Imo, ran a clinic in a mid-rise building in the 9800 block of Bissonett in southwest Houston.
Featured in a Houston magazine, The Drum, that caters to the Nigerian community, Uma Imo was lauded as "one of the most altruistic persons of our time."
The article said he funded schools and health centers in Nigeria.
But a federal indictment and an FBI agent’s statement aren’t so flattering.
Using a former employee as a snitch, the FBI said it learned Imo had set up a physical therapy clinic called City Nursing.
The snitch said patients were paid to come in.
Once there, some allegedly signed as many as 45 visit forms each, in order to fraudulently bill the government’s health insurance programs.
The FBI said some patients even got hush-money to not to report the fraud.
In all, the government said Imo and several co-conspirators bilked the government for some $30 million.
Where’d the money allegedly go?
The government said it went, in part, to buy Imo’s house in Cinco Ranch.
But nearly $2 million allegedly went to buy and ship dozens of tanker trucks from a lot in east Houston to Lagos, a port city in Nigeria.
Imo has hired one of Houston’s top criminal lawyers, Dick DeGuerin, who told 11 News:
"We are still reviewing the evidence and cannot yet comment on any specific allegations. Umawa Imo has been a very prominent and successful businessman in Nigeria, and has also operated several businesses here in the United States, including City Nursing. As with his other businesses, Mr. Imo hired people he believed he could rely on to properly run City Nursing. When Mr. Imo learned of some irregularities, he started an internal audit and ceased all Medicare billing. Mr. Imo specifically denies any intent to violate the law or to commit Medicare fraud."
The allegations of the outrageous scams and the arrests of some well-heeled Houston-area residents may have made the headlines, but is it making any difference? Health care fraud is a huge problem, maybe because it seems so easy to commit and is so lucrative -- if you don’t get caught.
"It is, it is easy to steal from," said Buchanan, who points out that the Obama administration has made fighting health care fraud a priority. "I think we’ve made a dent but this is a very target rich environment."
But shouldn’t the government do a better job catching fraud early?
"I think the public is demanding it," said Gray.
She sees hope that in the future, more fraud will be caught earlier, before the culprits have bilked the system for so much public money.
"We’re going to be able to pursue more of these kinds of cases," Gray said.
She predicts as medical records go digital, patterns of questionable claims will be easier to detect earlier.
As things are now, all that alleged fraud ran into the tens of millions of dollars in Houston before anyone noticed.
