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Grimy Times Exclusive: Texas Man Sentenced for Medicare Fraud Scheme
HOUSTON – A Richmond man has been sentenced to federal prison and ordered to pay restitution following his conviction for conspiracy to commit and committing health care fraud, announced United States Attorney Kenneth Magidson.
Emeka Daniel Orji, 43, pleaded guilty July 29, 2013, and was sentenced to 48 months in prison by U.S. District Judge Lynn Hughes. Orji was also ordered to pay $1.5 million in restitution to the Medicare program.
According to court documents, Orji admitted that between January 2006 and March 20, 2008, he agreed with Aghaegbuna ‘Ike’ Odelugo, of Supar Land, to split the profits of a scheme to defraud Medicare and Medicaid. Orji opened the Durable Medical Equipment (DME) company Spectrum Foundation Inc. and obtained a Medicare provider number.
He submitted approximately $4.4 million in false claims to Medicare and received payments totaling approximately $1.5 million. Orji said that most items billed to Medicare and Medicaid, including ‘Artho kits’ and power wheelchairs, either were not delivered at all, not medically necessary, not prescribed by a physician or upcoded from what was actually delivered.
The items in the kit primarily consisted of a double shoulder brace, a lower back brace, left and right elbow braces, left and right wrist braces, gloves, left and right knee braces, left and right ankle braces and left and right foot braces. Approximately 96% of the items billed were the Artho Kits and lymph edema pumps, 3% were power wheelchairs and accessories and the remainder was various other DME.
In addition, several of the items were upcoded – that is, the item billed to Medicare is paid at a higher rate than the actual item delivered. The upcoding was most prevalent in the back braces and heating pads. Using Spectrum, Orji and Odelugo submitted approximately $700,000 in claims to Medicare for the thoracic lumbar sacral orthotic brace – a full torso, rigid clamshell brace.
Odelugo also pleaded guilty and was sentenced last year to 72 months in prison. Orji was permitted to remain on bond and voluntarily surrender to a U.S. Bureau of Prisons facility to be determined in the near future. The case is being prosecuted by Assistant United States Attorney Al Balboni.
Key Facts
- State: Texas
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
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