Allegations of Medicaid and Medicare abuses have culminated in a 30-year jail sentence for the Houston-based owner of an ambulance company.

In a criminal prosecution, Chimaroke Echenwune was found guilty of bilking over $1.3 million from the Medicare and Medicaid systems.

The court assessed Echenwune a $10,000 fine and a 30-year sentence in Texas state prision.

Echenwune was accused of a variety of different Medicare abuses.

According to a press release from the office of Texas Attorney General Ken Paxton, Echenwune used his ambulance company Diamex EMS to submit fraudulent claims for reimbursement to Medicare and Medicaid.

The Texas AG says that with the cooperation of his wife and 13 emergency medical technicians, Echenwune billed the two systems for services provided to mentally handicapped patients.

Echenwune billed Medicare for transporting mentally handicapped patients to hospitals when they were actually taken to adult daycare facilities – a type of destination not covered by Medicare.

His company also made Medicare claims for services that were simply never rendered. Testimony by the caretakers of certain patients revealed those patients were never transported at all.

Other patients were billed as much as three times the actual cost of ambulance services.

One doctor who testified at trial said his signature appeared to have been forged on a medical authorization form. Echenwune’s co-defendants testified that he instructed them to falsify entries in patients’ records.

Court records show the defendant’s attorney filed a notice of appeal the day after Echenwune was sentenced.

The whistleblower investigation of Echenwune and Diamex EMS was initiated by Health Integrity LLC, a private federal contractor that handles data analytics and auditing for the Medicare system.

The investigation was carried out by the Medicaid Fraud Control Unit of the Texas Attorney General’s Office.

Medicare Abuses Under the False Claims Act

Although this investigation and prosecution was carried out by state authorities, many Medicare abuses can be brought to federal investigators’ attention by filing a whistleblower lawsuit, or qui tam claim, under the federal False Claims Act.

The False Claims Act allows persons with evidence of Medicare fraud to file a whistleblower lawsuit on behalf of the government. The U.S. Department of Justice then gets a chance to investigate the allegations and decide if it wants to intervene.

If the DOJ intervenes, it takes the place of the whistleblower as the plaintiff. However, the whistleblower remains involved in the case. If the case is successful, the whistleblower can expect to collect anywhere from 15 to 30 percent of the money recovered for the government.

That recovery can be much bigger than the amount allegedly bilked out of the government. As punishment for submitting false claims, the False Claims Act allows the government to recover up to three times the falsely claimed amount.

The defendant can also be on the hook for fines of $5,500 to $11,000 per claim.

Medicare abuses are a frequent subject of False Claims Act lawsuits. Practices like double or triple billing, up-coding, overbilling for cheaper drugs, or making claims for medically unnecessary services can cost government programs billions each year.

Whistleblowers who step up to stop Medicare abuses may stand to gain a significant incentive award and enjoy protection from employer retaliation provided by the False Claims Act.