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Man who defrauded Medicaid gets to keep more than $120,000
A Des Moines man who claimed to be providing skills to disadvantaged youth by taking them to the mall and to the movies has been ordered to pay just $15,000 in restitution after defrauding taxpayers of almost $140,000.
Franklin Nwankpa, 37, was convicted in April of first-degree fraudulent practices. He defrauded the government-run Medicaid program of $139,378 between January 2008 and September 2010.
Nwankpa, a former Iowa State University all-American runner, set up a remedial services company, Bright Star Resources, in 2008, that he ran out of his home. Although he is not a licensed health professional, Nwankpa allegedly went door to door in Des Moines' immigrant community and connected with children whom he "diagnosed" as having certain behavioral or socialization problems. He then had licensed professionals sign papers indicating the children were in need of remedial services, and he billed Medicaid for his time.
In one instance, he allegedly took six children to a movie and billed Medicaid at a rate of $88 per hour, per child. Assuming the outing consumed two hours of his time, Nwankpa would have collected $1,056 for that one trip to the movies.
State officials investigated and Nwankpa agreed to plead guilty to the charge of fraudulent practices. The Iowa Department of Inspections and Appeals filed a victim impact statement in the case on behalf of Iowa taxpayers, asking the judge to impose the maximum fine and prison term.
However, Polk County District Judge Glenn Pille sentenced Nwankpa to two years of probation and 186 hours of community service. Nwankpa was also ordered to pay $15,000 in restitution to the state. A 10-year prison sentence and a $1,000 fine were suspended.
While the specific terms of any plea agreement are not known, Polk County Attorney John Sarcone said his office agreed to probation when Nwankpa agreed to refrain from seeking a deferred judgment.
"We didn't oppose him getting probation because, realistically, in those situations, that's what the judges generally do anyway," Sarcone said.
Sarcone said the $15,000 in restitution was the amount requested by the state inspections department. However, the spokesman for the inspections department, David Werning, said the agency sought restitution for the full $139,378.
Polk County court files are often unclear as to the exact nature of plea bargains and the underlying basis for charges. Information related to those elements of a case are sometimes sealed from public view at the request of the county attorney's office.
Werning said Nwankpa was the "poster child" of Medicaid fraud, filing false billings for services he claimed to be providing through the state's remedial services program. That program, administered by the Iowa Department of Human Services, provides instruction in conflict resolution, as well as social, communication and interpersonal skills.
Nwankpa told The Des Moines Register he was the victim of "selective prosecution" by the state. He said he had about 20 clients at one time, ranging in age from 6 to 16 years old. The charges against him stemmed from some of his "field work," he said. He would take clients to the mall, to restaurants and to movies, then talk with them about the experience.
"For example, let's say I took a kid to the mall," he said. "I could say to him, 'OK, Johnny, watch me go into this store and watch how I act.' Then I go in, and he watches me, and then I come back out, and then I say, 'OK, Johnny, I want you to repeat what I just kind of done right now' - you know what I mean?
"That is skills teaching. It's not all about therapy all the time, you know?"
Nwankpa acknowledged taking some of his clients to the movies, such as the Will Smith drama, "The Pursuit of Happyness." He said he and the children then discussed the plot and any lessons they learned from the film. "I don't see what I did wrong," he said. "I'm angry about this."
State regulations say that remedial service providers like Nwankpa need not be licensed professionals, but the clients must undergo a face-to-face evaluation with a licensed health professional. Nwankpa appears to have skirted that requirement by targeting children whom he diagnosed. Other licensed professionals then "approved" his services based on the information he was giving them.
Department of Human Services spokesman Roger Munns said Nwankpa's services were evaluated by LifeWorks Inc. of Des Moines. He said the information that was then turned in to Medicaid appeared to be in order, so Nwankpa was paid for his services.
Nwankpa said that at one time he was certified by the state to provide family therapy. However, state records indicate he has never been licensed as a therapist or counselor. He was charged in 2005 with domestic assault with a deadly weapon or intent to injure, but the case was dismissed.
Nwankpa said he has not been barred from the Medicaid program and that he hopes to eventually resume serving disadvantaged youth. Last Wednesday, the Register asked Munns why Bright Star Resources was still listed by the state as an approved provider of remedial services. Munns said the agency typically removes people from that list only at the point where they have been sentenced on a conviction of fraud.
Nwankpa was sentenced on April 26. The Department of Human Services pulled Bright Star from the list hours after the Register's inquiry.
Public records indicate Nwankpa worked as a paraprofessional for the Des Moines public schools from February 2000 to September 2008, when Bright Star Resources was launched. Nwankpa said his job with the district entailed working with youth as a "case manager."
He was a standout runner for Iowa State in 1996, the same year he qualified for the Olympics as an alternate member of Nigeria's 4x100-meter relay team.
Spending, enrollment double in remedial services program
State spending on the remedial services program that was defrauded by Franklin Nwankpa has grown at an "alarming rate," according to the Iowa Department of Human Services.
The program, which is designed to improve clients' social and behavioral skills, cost $39.8 million in 2008. This year, it's expected to cost $80.6 million. Between 2008 and 2010, the number of Iowans served by the program doubled, from 5,000 to 10,000.
The skyrocketing cost isn't the state's only concern. The program is vulnerable to fraud, so changes are in the works. Beginning July 1, the state will attempt to improve the program's integrity through increased training, monitoring and credentialing of service providers.
"The entire area of remedial services has been a concern for Medicaid for the last year or so," said Department of Human Services spokesman Roger Munns. "We have not been satisfied with procedures in place to ensure quality services, and the program has grown much faster than anticipated."
One problem with the current program: Payments to Iowa's 130 remedial service providers are based in part on the providers' actual cost - so those providers have no incentive to be efficient in their work.
About 96 percent of the clients in the program are children, and most of them range from 4 to 17 years old. Their most common diagnoses are adjustment disorder, attention deficit hyperactivity disorder and oppositional defiant disorder.
In 2001, the inspector general at the Centers for Medicare and Medicaid Services reviewed Iowa's Rehabilitative Treatment Services Program and questioned $6.5 million in spending. That program was phased out in 2006 and replaced by the remedial services program, which the inspector general examined in 2008.
At that time, the inspector general found significant improvements in spending oversight but determined that controls were still insufficient. In one instance, a service provider was paid to watch a client play basketball and dodgeball.
- Clark Kauffman
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