HOUSTON--Jayshree Patel, M.D., 63, of Houston was sentenced to 78 months in prison for her role in a far-reaching scheme to defraud Medicare of more than $21 million, United States Attorney Don DeGabrielle announced last week.

At a Friday morning hearing, Judge Vanessa Gilmore sentenced Patel to a 78-month prison term for each of her 10 convictions for health care fraud, with the terms to run concurrently. Patel was also sentenced to three years of supervision after the jail time and is liable for restitution to Medicare in the amount of $9,477,349.

A federal jury in Houston returned the guilty verdict in October 2006, convicting Patel; Charles Frank Skripka Jr., M.D., 66; Pius James Ekiko, 44; and David Dennis Brown, 48, of health care fraud for their roles in the scam, which involved several tiers of illegal conduct., according to a statement from the U.S. Attorney's office. Dennis Brown was previously sentenced to 80 months imprisonment, and Harold Horatio Iyalla, aka "Prince Yellowe," who cooperated with the government and testified against the remaining co-defendants, was previously sentenced to 50 months imprisonment. Sentencing for Ekiko is set for Oct. 22 and for Skripka on Oct. 29.

Similar to other scams in the Houston area--where massive PWC fraud sparked the government's Operation Wheeler Dealer initiative in 2003--the scheme involved the payment of kickbacks by DME companies to recruiters, who solicited Medicare beneficiaries to get power wheelchairs. The recruiters then referred and transported beneficiaries to physicians to secure false or fraudulent CMNs that the DME companies would use to bill Medicare for the equipment, prosecutors said.

The evidence at trial established Patel and Skripka had been hired solely to authorize motorized wheelchairs for beneficiaries who clearly did not meet the Medicare guidelines to receive such a device, the statement said. Patel and Skripka routinely approved wheelchairs for as many as 30 to 80 patients a day without performing a physical exam or ordering any medical tests. Recruiters such as Brown promised beneficiaries free scooters and the payment of $50 to see doctors Patel and Skripka. Brown recruited patients from Louisiana and transported them 350 miles to Houston to see the physicians.

DME companies, such as Pius Ekiko's Horizon Medical Supply and Yellowe's First Choice Medical, then paid the doctor's office $200 for each fraudulent prescription and CMN, and also paid Brown and other recruiters as much as $1,000 per patient in order to be able to supply the equipment. Suppliers such as Ekiko would then use the fraudulent CMN to bill Medicare for a PWC but would instead deliver "the significantly less expensive scooter to the beneficiary, according to the statement. Medicare paid suppliers approximately $4,200 per wheelchair, while the scooters that were actually provided were only paid at a rate of $1,600.

The trial revealed that Patel falsely certified in excess of 1,900 Medicare beneficiaries for a motorized wheelchair.

The case was investigated jointly by the U.S. Department of Health and Human Services Office of Inspector General, the FBI and the Texas Attorney General's Medicaid Fraud Control Unit.