Opinion ID: 801968
Heading Depth: 3
Heading Rank: 2

Heading: Obisike Nwankwo6

Text: Nwankwo argues that there is insufficient evidence to tie him to the fraud at Onward, stating that the evidence shows that Nwankwo only found out about the fraud at Onward after his arrest and therefore could not have known about the unlawful purpose of his deliveries.7 However, there was credible evidence presented at trial that Nwankwo knew that the equipment that he was paid to deliver was not medically necessary for the beneficiaries but delivered it anyway.8 5 Additionally, as the district court observed, “[i]t is undisputed that Grant never filed a qui tam lawsuit. It is also undisputed that Grant never reported the Onward fraud to any person or agency connected with the Medicare program or to any law enforcement agency.” The district court also noted, “[o]n cross-examination . . . Grant admitted that he did not want to file a qui tam lawsuit unless he could profit from it and unless he could file it without any expense to himself.” Grant testified, “I wanted to make money” and, when asked, “Is there any other reason that you wanted to file this lawsuit?” Grant answered, “No.” 6 Nwankwo was sentenced to 21 months imprisonment followed by three years of supervised release and ordered to pay $29,057.70 in restitution to be paid jointly and severally with other defendants. 7 Nwankwo also argues that Okonkwo, a co-defendant in the case, testified that Nwankwo “never knew nor had knowledge of the illegal activities.” However, Okonkwo repeatedly also testified that he did not know whether Nwankwo knew of the conspiracy or knew that he was delivering unnecessary medical equipment. 8 Nwankwo argues that, “[a]fter hearing the government’s entire case over a period of six days and making a conscientious effort to examine the record in the light most favorable 7 Case: 11-20013 Document: 00511881596 Page: 8 Date Filed: 06/08/2012 No. 11-20013 The evidence shows that Nwankwo made at least nine deliveries of equipment ordered using the fraudulent prescriptions with Grant’s forged signature. Moreover, Moten testified Vinitski liked Nwankwo to deliver durable medical equipment ordered through the forged prescriptions because Nwankwo knew “how to make the people take the equipment even if they don’t want it” and knew “all the right things to say to make them keep it.” Testimony at trial showed that Nwankwo made repeated attempts to deliver equipment that were unsuccessful because the patients refused to accept the delivery or did not live at the address provided. Evidence presented at trial showed that Nwankwo knew that at least some of the equipment he was trying to get beneficiaries to accept was medically unnecessary. Nwankwo made two deliveries of motorized wheelchairs to Samuel Anderson and Lillie Brown, both of whom were able to walk and insisted they did not need the wheelchairs.9 Lillie Brown even told Nwankwo that she “wasn’t handicapped and that [her] doctor didn’t prescribe [her] one” when Nwankwo unsuccessfully attempted to deliver a motorized wheelchair to her. In November 2008, Nwankwo also delivered a wheelchair to Stanley Butler, who could walk without assistance. to the government, the court still had its doubts.” However, the citation Nwankwo uses to support this contention actually refers to Judge Atlas’s initial doubts about the case against Grant, not Nwankwo. 9 Samuel Anderson testified that when he told Nwankwo he did not need the wheelchair, Nwankwo responded by trying to convince him to take it anyway and saying, “[you] can take it and put it in the house and if [you] ever needed it, it would be available.” When Anderson replied that he still did not want the wheelchair, Nwankwo told him “maybe time you get ready for to use it, you might not be able to be qualified when you’ve been already approved and you can just take it at this time.” When Lillie Brown told Nwankwo that she did not need a wheelchair,” Nwankwo told her “[y]ou need one. Maybe you would like to order it.” When Nwankwo would not leave her front step after she refused to let him in, Brown told him she would call the police. 8 Case: 11-20013 Document: 00511881596 Page: 9 Date Filed: 06/08/2012 No. 11-20013 Finally, there was evidence presented that Nwankwo signed delivery slips that were fraudulently back-dated to appear to conform to Medicare regulations that required durable medical equipment be delivered to the beneficiary before the provider billed Medicare. For example, Moten testified that Nwankwo signed a delivery ticket dated September 30, 2008 when he made the delivery in late November 2008. Nwankwo signed two forms relating to this November 2008 delivery, both of which included the incorrect date, “9-10-08,” displayed prominently (once directly across from his signature and once directly above it). The jury reasonably could conclude that the fraudulent date was unmistakable to Nwankwo when he signed the forms at the subsequent November 23-25 delivery. Nwankwo cites United States v. Mackay, 33 F.3d 489, 494 (5th Cir. 1994), to support his contention that the evidence is not sufficient to prove that he agreed to deliver fraudulent equipment. See id. at 494 (“evidence that the companion agreed to transport the backhoe does not prove that he agreed with Mackay to transport a stolen backhoe”)). However, Mackay is factually distinguishable because in that case, there was no evidence that the companion (who was charged with conspiracy to transport stolen goods interstate) “knew the backhoe was stolen, let alone that he agreed to transport a stolen backhoe.” Id. at 494. Here, Nwankwo agreed to and was paid $2,910 from December 2008 to May 2009 for making equipment deliveries for Onward and knew that beneficiaries, such as Samuel Anderson and Lillie Brown, did not need or want the equipment he was delivering and that their doctors had not prescribed it. Therefore, unlike in Mackay, where there was no evidence the companion knew anything about the nature of article he was transporting, the jury in this case could reasonably have inferred that Nwankwo agreed to deliver fraudulently prescribed and ordered durable medical equipment because he knew the 9 Case: 11-20013 Document: 00511881596 Page: 10 Date Filed: 06/08/2012 No. 11-20013 beneficiaries did not need or want the equipment and had not been prescribed the equipment by their doctors. Nwankwo also intimates that the objective of the health care fraud conspiracy had been achieved before Nwankwo began making deliveries in December 2008. Nwankwo failed, however, to support this contention by explaining what “objective” of the conspiracy was accomplished by December 2008. Indeed, he does not develop this contention at all. In any event, there was evidence presented at trial that Nwankwo made a delivery of fraudulently prescribed equipment in late November 2008. Furthermore, the health care fraud could not have been completed without Nwankwo’s delivery of the equipment ordered through the forged prescriptions because Medicare requires “proof of delivery and training and education [of the beneficiary] on a particular product or service.”