People v. Nwadiei
| Decision Date | 24 December 1990 |
| Docket Number | No. 1-87-3576,1-87-3576 |
| Citation | 566 N.E.2d 470,152 Ill.Dec. 783,207 Ill.App.3d 869 |
| Parties | , 152 Ill.Dec. 783 The PEOPLE of the State of Illinois, Plaintiff-Appellee, v. Dominic NWADIEI, Defendant-Appellant. |
| Court | United States Appellate Court of Illinois |
Office of the State Appellate Defender, Chicago (Gordon H. Berry, of counsel), for defendant-appellant.
Neil F. Hartigan, Atty. Gen., Chicago (Terence M. Madsen, William P. Pistorius and David S. Meyerson, of counsel), for plaintiff-appellee.
Dominic Nwadiei was charged with multiple counts of Public Aid Vendor Fraud, (Ill.Rev.Stat.1983, ch. 23, par. 8A-3), conspiracy, (Ill.Rev.Stat.1983, ch. 38, par. 8-2), and theft, (Ill.Rev.Stat.1983, ch. 38, par. 16-1), for submitting fraudulent Medicaid claims to the state medicaid program. A jury found Nwadiei guilty on all counts, he was convicted and sentenced to concurrent terms of nine years for vendor fraud, and five years for theft and conspiracy. For the reasons below, we reverse and remand.
Dominic Nwadiei, a pharmacist, was charged with vendor fraud, theft, and conspiracy for submitting false Medicaid claims through nine pharmacies in Bellwood, Maywood, and Chicago. Ultimately, Nwadiei was prosecuted for vendor fraud and theft for claims submitted through four pharmacies, Northwest, 5th Avenue, Maywood, and Princeton. The charges of vendor fraud and theft arising from claims submitted through the the remaining five pharmacies, Cermak, Chif, A & E, Sharon's, and St. Lawrence, were nol prossed, although the record contains no formal certification of nolle prosequi. The conspiracy charge involved claims from all nine pharmacies.
At trial, the State introduced witnesses from the Illinois Department of Public Aid, ("IDPA"), who established the procedures for verification of claims submitted to the Medicaid program. First, doctors, enrolled in the Medicaid program as prescribers of medicine are assigned a unique "DEA" number by the Drug Enforcement Agency. IDPA assigns a unique "recipient" number to Medicaid patients, and a unique "provider" number to pharmacies that fill Medicaid prescriptions. To bill IDPA, the pharmacy must submit a claim with information concerning the medicine provided, dosage, and price. The claim must also include the pharmacy's provider number, the patient's recipient number, and the doctor's DEA number. When IDPA receives a claim, it is assigned a unique document control number, and all the information is entered into IDPA's computerized Medicaid Management Information System. ("MMIS.") IDPA then verifies the claims by comparing DEA, provider, and recipient numbers. Verified claims are paid, and rejected claims are held for investigation. IDPA sends the provider a report showing which claims were accepted, and which were rejected.
The State also introduced computer printouts from MMIS that showed Medicaid claims from Nwadiei's pharmacies, sorted according to DEA number, recipient number, and provider number. The printouts showed duplicated claims, and nine doctors, including Dr. Gumidyala and Dr. LaRoche, testified that most of the claims with their DEA numbers involved recipients who were not their patients. Four public aid recipients testified that most of the claims with their recipient number were for prescriptions their doctors had not given them. An ex-employee of a computer billing service testified that Nwadiei had personally brought claims from all the pharmacies in question to the service for processing.
The State also called Anthony Ruffolo, an accountant employed by the State Police. Ruffolo prepared four large exhibits, exhibits 244, 245, 246, and 247, which presented total number and dollar amounts for the Medicaid claims from each of the four prosecuted pharmacies. The labels on the exhibits stated, "AMOUNT OF MEDICAID DOLLARS PAID FOR FRAUDULENT CLAIMS TO [PHARMACY NAME] PER PHYSICIAN," and the exhibits contained several columns showing sub-totals of numbers of prescription and dollar amounts that were labelled as "false." Defense counsel objected to introduction of the exhibits, arguing that the labelling was prejudicial and addressed an ultimate issue in the case. The trial court overruled the objection, stating that the falseness and fraudulence of the claims was a reasonable inference. During Mr. Ruffolo's testimony explaining the exhibits, he made several statements that the claims represented in the exhibits were "false" and "fraudulent."
Two pharmacists, Mr. Ibeanu, and Mr. Azuh, who had been friends and business associates of Nwadiei as part owners of Nwadiei's pharmacies, testified to the dates Nwadiei's nine pharmacies had opened and closed. Mr. Ibeanu testified, under a grant of immunity, that Nwadiei had pressured him to sign fraudulent invoices from three pharmacies he owned with Nwadiei, the 5th Avenue, Maywood, and Northwest pharmacies. Mr. Azuh admitted to previous convictions of unemployment compensation fraud and delivery of a controlled substance, and also that deportation proceedings were pending against him. Azuh testified that he had engaged in fraudulent Medicaid billing with Nwadiei at the Princeton pharmacy.
Nwadiei testified on his own behalf, stating that he had been associated with Ibeanu and Azuh since 1982. Nwadiei had loaned Ibeanu a total of $22,000 for schooling, and had set up Ibeanu in business, listing himself as an owner of the pharmacies to guarantee repayment of the loans. Nwadiei denied falsifying any Medicaid billings.
On cross examination, the prosecution questioned Nwadiei at length whether Mr. Azuh, Dr. Gumidyala, Dr. LaRoche, Mr. Ruffolo, and Mr. Ibeanu had lied when they testified:
The prosecution also questioned Nwadiei at length concerning his operation of Savanna Drugs, a pharmacy that was named in none of the indictments against Nwadiei, and not connected to any of the Medicaid claims for which Nwadiei was prosecuted.
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