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Page 5 of 19

June 11, 2019

Two additional co-defendants in a recently reported home health fraud case have been sentenced to 6-10 years in prison and ordered to pay over $4.3 million each for their involvement.  Angela Avetisyan and Ashot Minasyan, the co-owners and operators of Fifth Avenue Home Health, paid kickbacks to Marina Merino and other patient recruiters to bring Medicare patients to a clinic owned by Robert Glazer.  In exchange, they received referrals from Glazer’s clinic for home health services that were allegedly medically unnecessary.  DOJ; USAO CDCA

Tagged in: Anti-Kickback and Stark, Healthcare Fraud, Home Health and Hospice, Lack of Medical Necessity,

May 29, 2019

Houston-based patient recruiter and home health clinic owner Egondu “Kate” Koko has been sentenced to over 15 years in prison and ordered to pay $14 million for participating in a $20 million kickback scheme involving Medicare beneficiaries.  Koko had plead guilty in October to paying bribes to both physicians and patients in order to earn between $9.5 and $25 million in ill-gotten gains, as well as to laundering money under another person’s identity and using proceeds from the fraud to buy a home.  DOJ

Tagged in: Anti-Kickback and Stark, Criminal Proceedings, Healthcare Fraud, Home Health and Hospice, Medicare,

May 20, 2019

A secret co-owner of Medsel Home Health Care Corp, a fake home health agency, has been sentenced to 2 years in prison and ordered to pay nearly $1 million for his role in a Medicare fraud scheme that caused at least $950,000 in unnecessary payments.  Dennys Hernandez and co-defendants Elanier Gonzalez Moncho and Rafael Arias submitted claims for services that were never provided.  Moncho, the nominee owner, was sentenced to a year and a half in prison, while Arias, the owner of multiple other home health agencies in Miami, was sentenced to 20 years.  DOJ

Tagged in: Healthcare Fraud, Home Health and Hospice, Medicare,

May 8, 2019

A South Florida woman who received kickbacks in exchange for patient referrals has been sentenced to over 7 years in prison. In exchange for at least $710,000, Yamilet Diaz allegedly referred Medicare beneficiaries to five home health agencies, aiding the agencies in unlawfully receiving over $1.6 million in reimbursements from Medicare that were tainted by the kickbacks. DOJ

Tagged in: Anti-Kickback and Stark, Criminal Proceedings, Healthcare Fraud, Home Health and Hospice, Medicare,

April 30, 2019

Home healthcare company Avenue Homecare Services, Inc, of Dracut, Massachusetts, will pay $8.3 million to resolve allegations that between 2013 and 2016 it defrauded the state's Medicaid program, MassHealth, by submitting false bills for unauthorized services not supported by a valid plan of care from a physician.  In some cases, Avenue submitted bills for home healthcare services for patients who were hospitalized at the time of the alleged services.  The settlement also requires the company to implement a compliance program to continue as a MassHealth provider.  MassAG

Tagged in: FCA State, Healthcare Fraud, Home Health and Hospice, Medicaid, Medical Billing Fraud,

April 30, 2019

Home healthcare company Amigos Homecare, LLC, of Lawrence, Massachusetts, will pay $2.13 million to resolve allegations that between 2014 and 2018 it defrauded the state's Medicaid program, MassHealth, by submitting false bills for unauthorized services not supported by a valid plan of care from a physician.  In some cases, Amigos submitted bills for home healthcare services for patients who were hospitalized at the time of the alleged services.  The settlement also requires the company to implement a compliance program to continue as a MassHealth provider.  MassAG

Tagged in: FCA State, Healthcare Fraud, Home Health and Hospice, Medicaid, Medical Billing Fraud,

April 18, 2019

Two former business partners behind three hospice and home healthcare agencies in the Las Vegas area have been sentenced for their roles in a $7.1 million Medicare fraud scheme.  Camilo Primero and Aurora Beltran—the owners of Advent Hospice, Angel Eye Hospice, and Vision Home Health Care—had been previously convicted of defrauding California’s insurance system in connection with another business, the Beltran House for disabled adults, and Primero had been excluded from participating in federal healthcare programs.  To get around the exclusion, the two filed false enrollment forms to Medicare, then submitted false claims for unqualified beneficiaries.  Each has been sentenced to three years of supervised release and ordered to pay $2,492,627.  USAO NV

Tagged in: Healthcare Fraud, Home Health and Hospice, Medicare,

April 4, 2019

Evelyn Mokwuah, a former administrator for Houston, Texas-based Beechwood Home Health and Criseven Health Management Corporation, was sentenced to ten years in prison for her role in the submission of approximately $20 million in false claims to Medicare.  According to the evidence at trial,  Mokwuah falsely certified and billed for patients who were not homebound or did not qualify for home health services; falsified patient records to show that patients were homebound when they were not; paid patient recruiters; and, paid doctors to certify false plans of care for Medicare beneficiaries.  DOJ

Tagged in: Criminal Proceedings, Healthcare Fraud, Home Health and Hospice, Lack of Medical Necessity,

March 26, 2019

Accurate Home Care, LLC, a Minnesota-based home health provider has agreed to pay $726,957.59 after voluntarily self-disclosing its violations of the False Claims Act in duplicated bills sent to both Medicaid and private insurers. Accurate had also admitted to fraudulently retaining payments from Medicaid even when Medicaid wasn't the primary insurer. USAO MN

Tagged in: FCA Federal, Healthcare Fraud, Home Health and Hospice, Medicaid, Medical Billing Fraud,

February 28, 2019

A former employee within the Wayne County Adult Services division of the Michigan Department of Health and Human Services has been charged with defrauding the state's Medicaid program. As an Independent Living Services Specialist, Eliza Yulonda Ijames was responsible for approving Medicaid beneficiaries for home health services. In violation of anti-kickback rules, however, she used her position to refer clients to agencies with which she had an improper financial relationship. AG MI

Tagged in: Anti-Kickback and Stark, Healthcare Fraud, Home Health and Hospice, Medicaid,

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