Gary doctor accused of health care scheme
BY Teresa Auch Schultz email@example.com March 26, 2013 4:26PM
Updated: April 28, 2013 6:44AM
A Gary doctor and his wife are accused of pocketing more than $3 million from Medicare and Medicaid in a scheme that saw the husband refer most of his patients to a homecare health company his wife owns.
The federal government is now suing Dr. Adolphus Anekwe; his wife, Angela Anekwe; her mother, Nellie Toney; and C&A Home Health Care Inc. to recover triple the amount they took plus fines of up to $11,000 for each false claim they filed.
Federal law requires doctors to certify that they referred a patient to a health-care provider in order for Medicaid and Medicare to reimburse the provider for services. Doctors are forbidden, however, from referring patients to a company in which the doctor has a financial interest.
That’s exactly what Dr. Anekwe did, according to the lawsuit, filed Tuesday in the U.S. District Court in Hammond.
He started referring patients to Gary-based C&A, which is owned by his wife and her mother, in August 2006, at first using the name of another doctor at his practice to cover his tracks, the lawsuit claims.
He stopped that in 2008, when he started using his own information.
He made mostly generic notes of having C&A monitor patients, the lawsuit claims, and did not follow up with their care.
C&A would then provide services that weren’t ordered or needed, and billed Medicare for $3 million and Indiana Medicaid for $342,560.
The case was originally brought to light by Bradley Stephens, who used to work as an account manager for Maxim Healthcare Services. He started investigating the case when a woman called saying her doctor, Anekwe, refused to certify services provided through Maxim and would only certify her through C&A.
He eventually decided to investigate the matter and filed a complaint in the U.S. District Court in Hammond on behalf of the government.
The federal government took over the case in January as an intervenor.