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Page 145 of 158

June 23, 2014

Cruz Sonia Collado, the owner and operator of Nestor’s Health Services, a now-defunct Miami home health care agency, pleaded guilty to a $6.5M million health care fraud scheme. According to the government, Collado and her co-conspirators operated Nestor for the purpose of billing Medicare for expensive physical therapy and home health care services that were not medically necessary or never provided. As part of the scheme, Collado allegedly also paid kickbacks and bribes to patient recruiters, in return for those recruiters providing patients to Nestor for these unnecessary or phantom home health care and therapy services. DOJ

June 20, 2014

Valnita Turner and Valdie Jackson, respective owners of the home health agencies Houston Compassionate Care and Jackson Home Healthcare, were sentenced for their roles in a $3M Medicare fraud scheme relating to the purchase of stolen patient information used to submit fraudulent claims to Medicare. Turner and Jackson also were charged with billing Medicare for medically unnecessary home health services never ordered by a doctor. Turner was sentenced to serve 151 months in prison and pay $3M in restitution. Jackson was sentenced to serve 12 months in prison and pay $1.5M in restitution. DOJ

June 19, 2014

Michael Mendoza, president of patient recruiting firm Network Resource Consultant Inc., pleaded guilty for his role in a $205M Medicare fraud scheme. According to court documents, Mendoza made an agreement with Lawrence Duran, owner of American Therapeutic Corporation, a now defunct partial hospitalization program located in Miami, under which Mendoza would refer residents living in assisted living facilities to ATC for medically unnecessary services in exchange for illegal kickbacks. Duran previously pleaded guilty and was sentenced to serve 50 years in prison for his role in orchestrating the fraud scheme. DOJ

June 18, 2014

Lizette Garcia, a former office worker at Anna Nursing Services Corp., a now defunct Miami home health care company, pleaded guilty in connection with a $7M health care fraud scheme under which Anna Nursing paid kickbacks and bribes to patient recruiters in return for providing patients to Anna Nursing for home health care and therapy services that were medically unnecessary or never provided. DOJ

June 13, 2014

Gwendolyn Climmons-Johnson, the owner and operator of Urgent Response EMS, a Houston area ambulance company, was sentenced to 97 months in prison and to pay roughly $1M for her role in a $2.4M Medicare fraud scheme. In October she had been convicted by a federal jury in Houston of four counts of health care fraud. According to evidence presented at trial, from January 2010 through December 2011, Climmons-Johnson and others conspired to enrich themselves by submitting false and fraudulent claims to Medicare for ambulance services that were medically unnecessary and/or not provided. DOJ

May 28, 2014

Kentucky-based hospital King’s Daughters Medical Center agreed to pay $40.9M to resolve allegations that it violated the False Claims Act by submitting false claims to the Medicare and Kentucky Medicaid programs for medically unnecessary coronary stents and diagnostic catheterizations. The government also alleged that several King’s Daughters physicians falsified medical records to justify these unnecessary cardiac procedures. Whistleblower Insider

May 22, 2014

An owner and operator of community mental health centers in Baton Rouge as well as a patient recruiter for a related facility in Houston were convicted for their roles in a $258M Medicare fraud scheme involving three facilities that filed fraudulent claims for psychiatric services that were unnecessary or never actually provided. The ongoing investigation into these three community mental health centers — Shifa Community Mental Health Center, Serenity Center and Shifa Community Mental Health Center — has so far resulted in the convictions of 17 employees of these facilities, including therapists, marketers, administrators, owners and the medical director. DOJ

May 22, 2014

Zahir Yousafzai, the co-owner or operator of four Detroit-area home health agencies involved in a $13.8M Medicare fraud scheme was sentenced to serve 72 months in prison and pay $4.1M in restitution. According to court records, Yousafzai and his co-conspirators paid and directed the payment of various medical professionals, including doctors, nurses, physical therapists and physical therapist assistants, to create fictitious patient files to document purported home health services that were never provided. The healthcare companies involved included First Care Home Health Care, Moonlite Home Care, Physicians Choice Home Health Care and Quantum Home Care. DOJ

May 19, 2014

Todd Farha, former CEO of WellCare, an operator of health maintenance organizations (HMOs) in several states, was sentenced to serve 36 months in prison for defrauding the Florida Medicaid program. According to court records and evidence at trial, Farha and others orchestrated a scheme to defraud the Florida Medicaid program from the summer of 2003 through the fall of 2007 by making fraudulent statements relating to expenditures for behavioral health care services. Under a prior settlement with the government, WellCare was required to pay $80M in restitution and forfeitures. In a related civil qui tam case filed under the whistleblower provisions of the False Claims Act, Wellcare also paid $137.5M in civil fines and penalties. DOJ

May 14, 2014

Richard Shannon, a patient recruiter for All American and Patient Choice, two home health care companies that provide skilled nursing and physical therapy services to Medicare beneficiaries in the greater Detroit area, was sentenced to 86 months in prison for his role in a $14.5M Medicare fraud scheme. The evidence showed that Shannon paid Medicare beneficiaries to sign blank documents for physical therapy services that were never provided and/or medically unnecessary. Shannon recruited destitute beneficiaries from housing projects and soup kitchens in the Detroit area, obtaining their patient information in exchange for cash and promises of prescription narcotics prescribed by co-conspirator physicians. DOJ
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