Dr. Ransome Njekia Etindi’s medical career in Texas ended after a series of disciplinary proceedings and a federal conviction arising from a nearly $60 million Medicare fraud scheme involving physician home visits and home-health services.
Etindi, a physician based in Waxahachie, Texas, was among several people prosecuted over a scheme that prosecutors said operated through a network of home-health companies in the Dallas area.
He ultimately pleaded guilty to conspiracy to commit health care fraud and was sentenced to 30 months in federal prison.
The case traced back to activities between approximately January 2009 and June 2013, when the defendants allegedly used several companies that appeared to operate separately but, according to prosecutors, functioned together.
One of the companies at the centre of the investigation was US Physician Home Visits (USPHV). Prosecutors said Medicare claims were submitted using physician provider numbers, including Etindi’s, irrespective of who actually performed the medical services.
According to the U.S. Department of Justice, claims were frequently submitted as though doctors had conducted comprehensive examinations lasting at least 90 minutes. Investigators found that many of the actual visits lasted only 15 to 20 minutes.
The alleged scheme also involved certifications for home-health services. Prosecutors said Etindi and another doctor signed Medicare Form 485 certifications for beneficiaries even when they were allegedly ineligible for the services, were not homebound or when the doctors lacked adequate knowledge of their medical conditions.
The scale of the billing was significant. The Justice Department said more than 97 per cent of USPHV's Medicare patients received home-health services, whether they needed them or not.
False certifications resulted in Medicare paying more than $40 million for fraudulent home-health services, prosecutors said.
Etindi's involvement was also detailed in court proceedings. Prosecutors said that beginning in January 2013, a majority of USPHV claims were submitted as though Etindi had personally provided the services, regardless of who had actually conducted the visits.
The federal investigation involved the FBI, the U.S. Department of Health and Human Services Office of Inspector General and the Texas Attorney General's Medicaid Fraud Control Unit. Etindi pleaded guilty before his sentencing in 2017.
On August 17, 2017, U.S. District Judge Jane Boyle sentenced Etindi to 30 months in federal prison and ordered him to pay $18,309,171.21 in restitution.
His co-defendant Myrna S. Parcon received a 10-year prison sentence and was ordered to pay more than $51.4 million in restitution.
Etindi's troubles with regulators had begun before the Medicare case reached its conclusion.
In February 2011, the Texas Medical Board publicly reprimanded him and suspended his medical licence until he completed a professional-boundaries programme.
The Board said the action followed a finding that Etindi had engaged in sexual conduct with a patient and that his hospital privileges were subsequently suspended.
The order also required him to have a chaperone present whenever he conducted physical examinations on female patients for 10 years.
Five years later, Etindi voluntarily surrendered his Texas medical licence.
A Texas Medical Board record dated October 14, 2016, states that he surrendered the licence in lieu of further disciplinary proceedings after being indicted and pleading guilty to Medicare fraud.
The criminal case therefore marked a dramatic reversal for a physician who had built a career in American medicine.
What began as disciplinary scrutiny over his professional conduct ultimately culminated in a federal fraud conviction, imprisonment and a multimillion-dollar restitution order.
Court records later also reflected civil proceedings under the False Claims Act, with Etindi and other defendants found liable in connection with claims arising from the Medicare scheme.
A federal court entered judgment against Etindi in 2019, with the civil damages calculated at more than $54.9 million, separate from the criminal restitution order.
The case remains one of the notable examples of how federal authorities pursued alleged fraudulent billing practices within the U.S. home-health industry, particularly schemes involving unnecessary services, false certifications and improper Medicare claims.