Archive

December 2, 2014

Luis Duluc, a Florida owner and operator of multiple physical therapy rehabilitation facilities, was sentenced to serve 11 years in prison for his role in organizing a $28.3M Medicare fraud scheme involving physical and occupational therapy services. Duluc was chairman and president of a Delaware holding company known as Ulysses Acquisitions Inc. which was used to purchase comprehensive outpatient rehabilitation facilities and outpatient physical therapy providers, including West Coast Rehab Inc. in Fort Myers, Florida; Rehab Dynamics Inc. in Venice, Florida;Polk Rehabilitation Inc. in Lake Wales, Florida; and Renew Therapy Centerof Port St. Lucie LLC in Port St. Lucie, Florida. Duluc admitted that he and his co-conspirators paid kickbacks to obtain, and stole, the personal identifying information of Medicare beneficiaries and used this information to create and submit false claims to Medicare through the clinics owned by Ulysses Acquisitions. DOJ

October 17, 2014

Two groups of Houston-based diagnostic centers agreed to pay more than $2.6M to settle allegations they violated the False Claims Act by engaging in improper financial relationships with referring physicians in violation of the Stark Statute. One group of centers, which operates under the name One Step Diagnostic, agreed to pay $1.2M. The other group of centers, consisting of Complete Imaging Solutions LLC doing business asHouston Diagnostics, Deerbrook Diagnostics & Imaging Center LLC,Elite Diagnostic Inc., Galleria MRI & Diagnostic LLC, Spring Imaging Center Inc. and West Houston MRI & Diagnostics LLC agreed to pay about $1.5M. The allegations originated from a whistleblower lawsuit filed by three whistleblowers under the qui tam provisions of the False Claims Act, who will receive an undisclosed award. DOJ

September 26, 2014

Detroit-area physician Dr. Vicha Janviriya pleaded guilty for making fraudulent referrals for home health care in a $1.3 million Medicare fraud scheme. He admitted that he falsified medical documentation which would be used to support false claims to Medicare for services that were never rendered or not medically necessary, or where the Medicare beneficiary referrals were obtained through the payment of kickbacks. DOJ

September 16, 2014

Wesley Harlan Kingsbury, general manager of the Southern California ambulance company Alpha Ambulance Inc., pleaded guilty to conspiracy to commit Medicare fraud. According to court documents, Kingsbury conspired with Alex Kapri and Aleksey (Russ) Muratov, the owners of Alpha Ambulance, as well as the training supervisor Danielle Medina, to bill Medicare for ambulance transportation services for individuals that Kingsbury knew did not need to be transported by ambulance. In addition, he instructed emergency medical technicians that worked at Alpha Ambulance to conceal the true medical condition of patients they were transporting by altering requisite paperwork and creating false reasons to justify the transportation services. DOJ

August 25, 2014

Zahid Imran, a Louisiana psychiatrist, was sentenced in federal court in Baton Rouge, Louisiana to serve 86 months in prison and to pay $43.5 million in restitution for his role in a $258.5 million Medicare fraud scheme involving partial hospitalization psychiatric services. According to court documents, Dr. Imran served as the medical director of Shifa Community Mental Health Center of Baton Rouge, and co-owned Serenity Center of Baton Rouge and Shifa Community Mental Health Center of Texas. As part of the scheme, Imran admitted mentally ill patients to the facilities, some of whom were inappropriate for partial hospitalization, and then re-certified the patients’ appropriateness for the program in an effort to continue to bill Medicare for services. Imran pleaded guilty on May 13, 2014, to conspiracy to commit health care fraud. DOJ

August 7, 2014

Gary Lang, a CEO of an Atlanta-area hospital and Tracey Cota, the co-owner and chief operating officer of the Atlanta-based medical clinic chain Hispanic Medical Management, pleaded guilty for paying illegal kickbacks to clinics in exchange for Medicaid patient referrals. According to the government, Cota conspired with Lang and other executives from Atlanta-area hospitals and from a hospital on Hilton Head Island to pay kickbacks to Hispanic Medical Management for the referral of its patients, primarily undocumented Hispanic women seeking prenatal care services. These referrals ultimately resulted in Medicaid reimbursements of over $100 million to the hospitals. DOJ

July 21, 2014

Alabama-based hospital system Infirmary Health System Inc., along with two affiliated clinics and Diagnostic Physicians Group, agreed to pay $24.5M to resolve government allegations they violated the False Claims Act, the Anti-Kickback Statute and the Stark Law by paying or receiving financial inducements for medical referrals covered by Medicare.Whistleblower Insider

July 11, 2014

Luis Alberto Garcia Perojo of Florida was sentenced to serve 4 years in prison and ordered to pay $6.2M in connection with a $10.5M Medicare fraud scheme involving physical and occupational therapy services. From November 2007 through August 2009, Garcia submitted on behalf of Renew Therapy Center, an outpatient rehabilitation facility he helped operate, roughly $10.5M in fraudulent claims for reimbursement to Medicare for therapy services not legitimately prescribed or provided. DOJ

July 1, 2014

Detroit-area physician, Walayat Khan, pleaded guilty for his role in a $7M health care fraud scheme. According to court documents, beginning in January 2009, Dr. Khan and others agreed that he would refer Medicare beneficiaries to Advance Home Health Care Services, Inc., Perfect Home Health Care Services, LLP and other Detroit-area home health care agencies for medically unnecessary home health services. Dr. Khan signed medical documents for these beneficiaries, falsely certifying they required home health care and they were under his care. The complicit home health care agencies then used Dr. Khan’s false documents to support their claims to Medicare for home health services that were never rendered or not medically necessary. 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