KANSAS CITY– A former physician pleaded guilty in federal court Wednesday to falsely certifying that products and tests were medically necessary for more than 2,000 Medicare and Medicaid patients in Missouri whom he never met or examined, according to the United State's Attorney.
“This physician violated his oath and abused his trusted position to support a fraud scheme that cost taxpayers millions of dollars,” said U.S. Attorney Teresa Moore. “He will be held accountable for the specific and essential role he played in the deceit as the larger investigation into other aspects of this criminal scheme unfolds in other courtrooms across the nation.”
Oluwatobi Alabi Yerokun, 36, of Washington, D.C., pleaded guilty before U.S. District Judge Howard F. Sachs to one count of conspiracy to make false statements related to health care matters.
“Physicians who submit false claims to Medicare and Medicaid for their own financial gain undermine the economy and integrity of federal health care programs,” said Curt L. Muller, Special Agent in Charge with the Department of Health and Human Services, Office of the Inspector General (HHS-OIG). “HHS-OIG is committed to working with our law enforcement partners to ensure that bad actors are held accountable for their health care fraud schemes.”
From February 2019 to April 2021, certain individuals and entities – including marketing, physician recruiting, and telemedicine companies – developed a scheme that targeted the Medicare and Medicaid programs to obtain millions of dollars in reimbursements from those programs.
Yerokun, a physician who practiced medicine in the state of Missouri, among other places, contracted with a staffing company to work as a telemedicine provider. The firm, identified in court documents as Company A, gave Yerokun access to electronic portals so that he could receive information about the patients assigned to him. Yerokun reviewed the information and electronically signed the patient forms and orders he received from Company A.
By pleading guilty, Yerokun admitted that he signed the patient forms and certified that durable medical equipment or genetic tests were medically necessary. For the genetic tests, he also signed a separate letter of medical necessity. Yerokun knew that his orders would be used to submit claims for payments to Medicare and Medicaid, which paid claims submitted by the durable medical equipment companies and testing laboratories.
Yerokun had no doctor-patient relationship with the Medicare or Medicaid beneficiaries for whom he signed orders and certified medical necessity. He did not see or communicate with any of them. Before Yerokun signed the orders, he made little effort to find out how or from whom the patient information was obtained, who collected the information, the qualifications of any person gathering or providing the information, or whether the information was accurate and complete. Yerokun provided no follow-up care for these patients after he signed the orders for them to receive durable medical equipment or genetic testing.
By knowingly and willfully electronically signing the orders, Yerokun made false and fraudulent statements and documents certifying medical necessity. The statements and documents were false because, among other things, Yerokun did not have adequate information to assess medical necessity for the beneficiaries.
Yerokun rarely, if ever, declined to sign any orders he received from Company A. For many or most of the patients, less than a minute elapsed between when Yerokun accessed the patient’s information through the electronic portal and when he signed the order for durable medical equipment or genetic testing. Accordingly, he knew his false and fraudulent statements and documents were untrue when he made them.
The orders that Yerokun signed were submitted to durable medical equipment companies and clinical testing laboratories, many of whom paid illegal kickbacks to individuals and entities unknown to Yerokun.
Yerokun ordered durable medical equipment and genetic tests for 2,184 Medicare beneficiaries between March 2019 and April 2021. Company A paid Yerokun approximately $20 for each order that he signed, for a total of $44,860.
The orders that Yerokun signed for durable medical equipment for Medicare beneficiaries caused Medicare to be billed more than $6.2 million, and Medicare actually paid those companies almost $3.1 million.
The orders that Yerokum signed for genetic testing for Medicaid beneficiaries caused Medicaid to be billed more than $2.5 million by the laboratories, and Medicaid actually paid those companies almost $525,000.
Under federal statutes, Yerokun is subject to a sentence of up to five years in federal prison without parole. The maximum statutory sentence is prescribed by Congress and is provided here for informational purposes, as the sentencing of the defendant will be determined by the court based on the advisory sentencing guidelines and other statutory factors. A sentencing hearing will be scheduled after the completion of a presentence investigation by the United States Probation Office.