Archive

November 7, 2016

Badar Ahmadani, co-owner of Detroit home health care company Hands on Healing Home Care Inc., was sentenced to 96 months in prison and to pay roughly $38 million in restitution for his role in a Medicare fraud scheme that caused approximately $33 million in losses.  According to evidence presented at trial, Ahmadani and his co-conspirators obtained patients by paying cash kickbacks to recruiters, who in turn paid cash to patients to induce them to sign up for home health care with companies owned by co-defendant Zafar Mehmood: Access Care Home Care Inc., Patient Care Home Care Inc., Hands On Healing Home Care Inc. and All State Home Care Inc.  The evidence also showed that Mehmood and Ahmadani paid kickbacks to physicians to refer patients to the companies for home health care services that were medically unnecessary and/or not provided.  Mehmood was previously sentenced to 360 months in prison and to pay roughly $40.5 million in restitution.  DOJ

November 7, 2016

Pennsylvania-based medical device manufacturer Biocompatibles Inc., a subsidiary of British-based BTG plc, pleaded guilty and agreed to pay more than $36 million for violating the False Claims Act and Food, Drug and Cosmetic Act by misbranding its embolic device LC Bead, which is used to treat liver cancer, among other diseases, and by marketing and selling the product for uses not approved by the FDA.  The matter originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Ryan Bliss who oversaw Bicompatibles’ North American marketing.  He will receive a whistleblower award of approximately $5.1 million from the proceeds of the government’s False Claims Act recovery.  Whistleblower Insider

October 31, 2016

Tariq Mahmood, former owner and operator of several rural hospitals across Texas, was ordered to pay roughly $1.2 million for violating the False Claims Act following his conviction for committing health care fraud and for aggravated identity theft.  DOJ (EDTX)

October 28, 2016

Zafar Mehmood, owner of several Detroit home health care companies was sentenced to 360 months in prison and to pay roughly $40.5 million for his role in a Medicare fraud scheme that caused approximately $33 million in losses.  According to evidence presented at trial, Mehmood participated in a scheme in which he obtained patients by paying cash kickbacks to recruiters, who in turn paid cash to patients to induce them to sign up for home health care with Mehmood’s companies: Access Care Home Care Inc., Patient Care Home Care Inc., Hands On Healing Home Care Inc. and All State Home Care Inc.  The evidence also showed that he paid kickbacks to physicians to refer patients to the companies for unnecessary home health care services.  DOJ  

October 28, 2016

Albert Einstein Healthcare Network and the Einstein Practice Plan agreed to pay roughly $970,000 to resolve charges they violated the False Claims Act by improperly billing Medicare for services submitted on behalf of a cardiologist that were not medically necessary or lacked sufficient documentation.  After it discovered the problem, the Einstein defendants took corrective action to resolve the improper payments and disclosed the matter to the government.  DOJ (EDPA)

October 25, 2016

Kansas City-based Best Choice Home Health Care Agency Inc. and its owner Reginald King agreed to pay $1.8 million to resolve allegations they violated the False Claims Act by paying kickbacks for the referral of Medicaid-covered patients for home and community-based healthcare services.  According to the government, King paid kickbacks to patient transporter Christopher Thomas for referrals to Best Choice.  The allegations originated in a whistleblower lawsuit filed by Thomas under the qui tam provisions of the False Claims Act.  Thomas will receive a whistleblower reward of $43,178, which represents 10 percent of the federal share of the settlement minus the amount he received in kickbacks.  DOJ

October 24, 2016

Los Angeles licensed occupational therapist Keith Canlapan pleaded guilty for his role in a $2.6 million Medicare fraud scheme that involved billing for occupational therapy services not provided.  As part of his guilty plea, Canlapan admitted that through his employer, occupational clinic JH Physical Therapy, he billed Medicare for occupational therapy services never provided.  The patients instead received massage and acupuncture services which are not reimbursable under Medicare.  DOJ

October 24, 2016

Life Care Centers of America Inc., the Tennessee-based operator of more than 220 skilled nursing facilities, and its owner Forrest L. Preston, agreed to pay $145 million to resolve charges that Life Care violated the False Claims Act by submitting claims to Medicare and TRICARE for rehabilitation therapy services that were not reasonable, necessary or skilled.  It is the largest settlement with a skilled nursing facility chain in DOJ’s history.  The allegations originated in a whistleblower lawsuit filed by former Life Care employees Tammie Taylor and Glenda Martin under the qui tam provisions of the False Claims Act.  They will receive a whistleblower award of $29 million from the proceeds of the government’s recovery.  Whistleblower Insider

October 24, 2016

Daybreak Partners, LLC, a holding company for a number of subsidiaries that operate and manage skilled nursing facilities throughout Texas, agreed to pay $5.3 million to resolve allegations that they billed Medicare and Medicaid for materially substandard nursing services.  Specifically, the government alleged that skilled nursing services provided at four nursing facilities Daybreak owned and managed (Deerings Nursing and Rehabilitation, L.P., Mansfield Nursing and Rehabilitation, L.P., Marine Creek Nursing and Rehabilitation, L.P. and Mineral Wells Nursing and Rehabilitation, L.P.) were materially substandard and/or worthless because Daybreak: (i) failed to follow appropriate fall protocols; (ii) failed to follow appropriate pressure ulcer and infection control protocols; (iii) failed to properly administer medications; (iv) failed to follow doctors’ orders; (v) failed to provide appropriate mental health treatment; (vi) failed to answer several residents’ call lights promptly; (vii) failed to institute appropriate infection control measures; (viii) failed to provide a habitable living environment, adequate equipment, and needed capital expenditures; and (ix) failed to investigate and report serious incidents to appropriate authorities on several occasions.  DOJ (NDTX)  

November 11, 2016

– New York announced the arrest of attorney Anthony Cornachio, 74, of Garden City and charges against NRI Group, LLC (“NRI”) and Canarsie A.W.A.R.E., Inc. (“Canarsie”), which are Medicaid-enrolled drug treatment programs controlled by Cornachio. The Attorney General’s Medicaid Fraud Control Unit (“MFCU”) also charged three-quarter housing operators Yury Baumblit, 66, and Rimma Baumblit, 60, of Brooklyn, and their company Back on Track Group, Inc. In papers filed in New York City Criminal Court, Kings County and New York State Supreme Court, Kings County, prosecutors allege that Yury Baumblit and Rimma Baumblit, in exchange for payments from Cornachio’s companies, forced residents of their “three-quarter” homes to either face eviction or attend NRI and Canarsie regardless of the residents’ actual need for drug treatment services. During the course of this scheme, which dates back to at least 2013, Cornachio allegedly paid Back on Track Group, Inc. over $900,000.00 in illegal kickbacks. As a result of this kickback scheme, prosecutors allege that Cornachio, through NRI and Canarsie, submitted, and caused to be submitted, at least $1.7 Million in false claims for reimbursement to Medicaid. NY