[MM Curator Summary]: Apparently the patriarchy and toxic masculinity in Nigerian culture is not a sufficient defense against fraud charges in Alabama.
Judges on the U.S. Court of Appeals for the 11th Circuit upheld last week the 30-year sentence of an Alabama doctor who prescribed high numbers of opioids and fraudulently billed for allergy treatment.
A jury found Dr. Patrick Ifediba and his sister, Ngozi Justina Ozuligbo, guilty in 2019 on dozens of counts of health care fraud and controlled substances violations. U.S. District Court Judge David R. Proctor sentenced Ifediba to 30 years and Ozuligbo to three years in prison.
Ifediba challenged his conviction because the court barred evidence of his good care to other patients, failed to address wrongdoing by an alternate juror and incorrectly calculated the amount of unlawfully prescribed opioids, according to court documents.
Ifediba operated Care Complete Medical Clinic in Birmingham with his wife, Dr. Uchenna Ifediba. According to court documents, neither one specialized in pain care, but they prescribed high numbers of opioids such as oxycodone and fentanyl. About 85 percent of the patients at CCMC received opioid prescriptions, according to the U.S. Department of Justice.
“CCMC attracted patients who were willing to wait over three hours in a dirty, crowded waiting room to receive prescriptions for controlled substances,” appeals court judges wrote in the opinion. “The clinic stayed open until 10:00 PM to accommodate them.”
Authorities in the case estimated Ifediba unlawfully prescribed between 30,000 and 90,000 kilograms of drugs. The doctor said the true estimate should have been between 1,000 and 3,000 kilograms, which would have reduced his sentence. Judges on the appeals court upheld the long sentence and agreed with the way federal investigators calculated the volume of drugs.
In addition to the opioid prescriptions, investigators also found that Ifediba performed costly allergy tests on almost all patients with insurance. He also prescribed expensive immunotherapy treatments for many patients, including some who tested negative for allergies.
The allergy tests cost more than $500 per patient and shots cost $2,660, according to the court opinion. Staff at Blue Cross Blue Shield of Alabama initially flagged the high numbers of allergy treatments and notified federal authorities, according to court documents. When the insurer moved to audit the clinic, staff members changed documents and test results to support treatment.
During the trial, an alternate juror violated court instructions and did online research about the case and discussed it with coworkers, according to the opinion. The juror was dismissed, but Ifediba argued more should have been done to determine whether the alternate discussed findings with other jurors.
Ozuligbo also challenged her conviction, arguing that she should have been allowed to present evidence of Nigerian cultural norms that required her to obey her brother. She worked as a nurse with a company that administered allergy tests and treatment but remained on site at CCMC.
“There was more than sufficient evidence to demonstrate that CCMC defrauded insurers through an allergy fraud scheme,” judges wrote in the opinion. “The only question is whether Ozuligbo was a knowing and voluntary participant in the conspiracy.”
Although Ozuligbo said she was just an employee, medical records showed she had signed and recorded negative allergy tests and then administered treatments the patients didn’t need.
Ifediba was convicted on 14 counts of unlawful distribution of controlled substances, 10 counts of health care fraud and one count of conspiracy to commit money laundering, among other charges. Ozuligbo was convicted of nine counts of health care fraud and one count of conspiracy to commit money laundering, plus some additional charges.
U.S. Attorney for the Northern District of Alabama Prim F. Escalona made a statement in 2020 when Ifediba was sentenced.
“Physicians who choose to deal drugs while hiding behind their white coats are no different than drug dealers who hide in alleys,” Escalona said. “The greed of Dr. Ifediba contributed to the ongoing opioid crisis that is plaguing our communities.