Archive

February 10, 2015

Orelvis Olivera, the owner of Miami home health care agency Acclaim Home Healthcare Inc., pleaded guilty for his role in a $6.9M Medicare fraud scheme.  Olivera admitted he and his co-conspirators billed Medicare for expensive physical therapy and home health care services not medically necessary and paid kickbacks and bribes to patient recruiters in exchange for patient referrals.  DOJ

February 9, 2015

Wesley Harlan Kingsbury, general manager of California-based Alpha Ambulance Inc., was sentenced to 78 months in prison for his role in a $5.5M Medicare fraud scheme under which his company billed Medicare for ambulance transportation services for individuals that did not need them.  DOJ

February 6, 2015

Oklahoma-based Hospice care provider Good Shepherd Hospice Inc.agreed to pay $4M to resolve allegations it submitted false claims for hospice patients who were not terminally ill. Specifically, the government contended Good Shepherd pressured staff to meet admissions and census targets and paid bonuses to staff, including hospice marketers, admissions nurses and executive directors, based on the number of patients enrolled even if they were not eligible for hospice care. The settlement resolves allegations first raised by former Good Shepherd employees Kathi Cordingley and Tracy Jones in a whistleblower lawsuit they filed under the qui tam provisions of the False Claims Act. They will receive a whistleblower award of approximately $680,000. DOJ

February 6, 2015

A federal jury in Detroit convicted unlicensed Detroit physician Wilfred Griffith for his participation in a nearly $4.7M fraud scheme. According to evidence presented at trial, Griffith worked as an unlicensed physician at Phoenix Visiting Physicians in 2010 and 2011 where he treated Medicare beneficiaries and used prescription pads pre-signed by Dr. Dwight Smith to prescribe medicine. He also referred Medicare beneficiaries to Detroit-area home health company Cherish Home Health Services Inc. in exchange for kickbacks. Griffith used the names and signatures of Dr. Smith and two other Detroit-area physicians to certify the beneficiaries were homebound and needed home health services when they did not. DOJ

February 5, 2015

Minnesota-based medical device manufacturer ev3 Inc. (formerly known as Fox Hollow Technologies Inc.) agreed to pay $1.25M to resolve allegations it violated the False Claims Act by causing certain hospitals to submit false claims to Medicare for unnecessary inpatient admissions related to minimally-invasive atherectomy procedures for removing hardening of the arteries. According to the government, Fox Hollow sold the Silver Hawk Plaque Excision System for these procedures and advised hospitals to bill them as more expensive inpatient procedures, as opposed to less costly outpatient procedures, to artificially increase their Medicare reimbursement claims. The charges originated with a whistleblower lawsuit was filed under the qui tam provisions of the False Claims Act by former Fox Hollow sales representative Amanda Cashi. She will receive a whistleblower award of $250,000. DOJ

February 3, 2015

Medical device maker Atrium Medical Corporation, Maquet Holding B.V. & Co. KG, Maquet Cardiovascular LLC, and Maquet Cardiopulmonary AG were permanently enjoined from distributing adulterated and misbranded medical devices. According to the government, Atrium — which manufactures medical devices for cardiovascular-related uses, including chest drains, surgical meshes, vascular grafts and stent systems — was not complying with the FDA’s current good manufacturing practice requirements for medical devices which are designed to ensure the devices are safe and effective and otherwise in compliance with the federal Food, Drug and Cosmetic Act. DOJ

February 3, 2015

Ernesto Fernandez pleaded guilty and was sentenced to 10 years in prison in connection with a long-running $6.2M Medicare fraud scheme involving Miami-based home health care agency Professional Medical Home Health LLC. Fernandez was an owner and operator of Professional Home Heath and also the owner and operator of two other South Florida home health agencies where he caused patient documentation to be falsified, and planned, organized and oversaw the submission of fraudulent claims to the Medicare program. Juan Valdes also pleaded guilty to the same scheme and was sentenced to 2 years in prison. He was a patient recruiter for Professional Home Health and solicited kickbacks and bribes from the owners and operators of Professional Home Health in exchange for providing beneficiaries to allow Professional Home Health to bill Medicare for home health services that were not medically necessary or not provided. Fernandez and Valdes are the seventh and eighth defendants to be sentenced in connection with the fraudulent schemes at Professional Home Health. DOJ

February 2, 2015

Tennessee-based Community Health Systems Professional Services Corporation and three affiliated New Mexico hospitals agreed to pay $75M to settle allegations they violated the False Claims Act by making illegal donations to county governments which were used to fund the state share of Medicaid payments to the hospitals. The allegations were first raised in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former Community Health revenue manager Robert Baker. He will receive a whistleblower reward of $18,671,561 as his share of the government’s recovery. DOJ

January 30, 2015

Pharmaceutical company Laclede Inc. and its president Michael A. Pellico entered into a consent decree of permanent injunction concerning the distribution of unapproved over-the-counter vaginal drug products sold under the name Luvena Prebiotic. According to the government, Laclede’s sale and distribution of the Luvena Prebiotic products violated various provisions of the Federal Food, Drug, and Cosmetic Act because they did not have the required FDA approval. DOJ

January 29, 2015

Four South Florida residents were sentenced in connection with a long-running $6.2M Medicare fraud scheme involving Professional Medical Home Health LLC, a Miami home health care agency operated for the purpose of billing the Medicare program for expensive physical therapy and home health services that were not medically necessary or actually provided. Dennis Hernandez was sentenced to 120 months in prison and to pay $1,438,186; Jose Alvarez was sentenced to 120 months in prison and to pay $2,972,570; Joel San Pedro was sentenced to 97 months in prison and to pay $4,938,432; Alina Hernandez was sentenced to 24 months in prison and to pay $204,526.05. DOJ