Friday, February 25, 2011

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Houston Man Sentenced To Prison For Health Care Fraud In Case Investigated by State and Federal Officials

The following news release was issued by the United States Attorney for the Southern District of Texas on Feb. 24, 2011:

OWNER OF NEW HAMPSHIRE DME STORE SENTENCED TO PRISON FOR HEALTH CARE FRAUD AND AGGRAVATED IDENTITY THEFT

(HOUSTON) – A Nigerian national and Houston resident has been sentenced to prison and ordered to pay more than $1.5 million in restitution to Medicare for health care fraud and aggravated identity theft, United States Attorney José Angel Moreno announced today.

Mento Nnana Kaluanya, 50, born in the Federal Republic of Nigeria, was sentenced by U. S. District Judge Nancy Atlas to 70 months in prison and to pay $1,573,042.52 in restitution to the Medicare Program on Wednesday, Feb. 23, 2011. Kaluanya, who pleaded guilty to health care fraud and aggravated identity theft on March 1, 2010, was the sole owner of HyCentral Medical Supplies and Equipment, (“HyCentral”) a durable medical equipment (“DME”) company set up in Derry, New Hampshire. HyCentral billed Medicare for approximately $3.9 million worth of DME and was paid approximately $1.6 million between May 1, 2006 and Dec. 11, 2008. The $3.9 million worth of claims were primarily for Texas Medicare beneficiaries, and were for DME that was not ordered or prescribed by treating physicians, that was not medically necessary, that was not delivered to some beneficiaries, and that was not wanted by other beneficiaries.

In deciding upon the sentence she ultimately handed down, Judge Atlas applied an enhancement for “sophisticated means” based upon facts presented proving that Kaluanya established a false storefront business out of state, in New Hampshire, in order to improve the success of his fraud plan, and he created false and fraudulent patient files to make his fraud harder to detect. Judge Atlas also applied an abuse of trust enhancement to the sentence noting that Medicare had entrusted Kaluanya not to submit false and fraudulent claims when he signed the certification of his Medicare application. Documents obtained during the investigation revealed that Kaluanya did not have any of the required Medicare documentation for claims filed on behalf of approximately 300 Medicare beneficiaries, and much of the documentation that did exist was incomplete and inaccurate. Physician orders with the forged signatures of at least twelve (12) Houston area physicians were found in the documentation.

Kaluanya was taken into custody at the conclusion of yesterday’s sentencing hearing to begin serving his sentence. In addition to the prison term, Kaluanya must also serve a three year term of supervised release.

The charges against Kaluanya are the result of a joint investigation conducted by the Office of Inspector General of the Department of Health and Human Services in Boston, Massachusetts and Concord, New Hampshire, and the Texas Medicaid Fraud Control Unit. Assistant United States Attorney Julie Redlinger prosecuted the case.