In the Courts

On March 7, 2011, in United States v. Isiwele, No. 10-40347, the United States Court of Appeals for the Fifth Circuit, in an opinion authored by Judge Carolyn Dineen King, affirmed the district court convictions of Enitan Osagie Isiwele on 16 counts of health care fraud and a single count of conspiracy to pay illegal remunerations, but vacated his corresponding sentence. As the Fifth Circuit held that the fixed allowances provided by Medicare/Medicaid provided the proper basis for calculating the loss amount under the U.S. Sentencing Guidelines, the court remanded the case for resentencing on these limited grounds.

Isiwele, the owner of a durable medical equipment (“DME”) supply company entitled Galaxy Medical Supply, had previously been convicted for his role in a scheme to fraudulently bill Medicare and Medicaid for power wheelchairs. Specifically, Isiwele was accused of compiling billing information from Medicare/Medicaid beneficiaries in both elderly and low-income communities, via the use of a recruiter. Once Isiwele had the information, without the participation and/or knowledge of the unsuspecting beneficiaries, he proceeded to submit power wheelchair claims for reimbursement from Medicare/Medicaid using an exception that had eliminated the requirement of specific documentary evidence for replacement DME of this sort.