Healthcare Fraud

September 8, 2014

Cruz Sonia Collado, the owner and operator of now defunct home health care company Nestor’s Health Services was sentenced to 75 months in prison and ordered to pay $6.5 million in restitution for her participation in a $6.5 million Medicare fraud scheme under which she paid kickbacks and bribes to patient recruiters in return for their providing patients to Nestor’s for home health care and therapy services that were medically unnecessary and, in many instances, not provided. DOJ

September 5, 2014

Life Care Services LLC, a manager of skilled nursing facilities based in Des Moines, Iowa, and CoreCare V LLP, doing business as ParkVista, a skilled nursing facility in Fullerton, California, agreed to pay a total of $3.75 million for causing the submission of false claims to Medicare for unreasonable or unnecessary rehabilitation therapy purportedly provided by RehabCare Group East Inc., a subsidiary of Kindred Healthcare Inc. DOJ

August 26, 2014

Annarella Garcia, a co-owner of Professional Medical Home Health LLC, a Miami home health agency, was sentenced to 70 months in prison and ordered to pay $6.2 million in restitution for her participation in a health care fraud scheme involving the now defunct home health care company. According to the government, Garcia and others engaged in a scheme to bill Medicare for expensive physical therapy and home health care services that were not medically necessary or were not provided. 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 20, 2014

Muhammad Aamir, owner of the three Michigan home health agencies Prestige Home Health Services, Platinum Home Health Services, and Empirical Home Health Care, pleaded guilty for his role in a $22 million home health care fraud scheme. Specifically, Aamir and his co-conspirators billed Medicare for home health care services that were not actually rendered, not medically necessary, and procured through paying illegal kickbacks. DOJ

August 15, 2014

Mihran “Mike” Meguerian, former owner of Los Angeles medical clinic management company Med Serve Management pleaded guilty in connection with his role in a scheme to defraud Medicare. Meguerian admitted overseeing medical clinics that wrote prescriptions for medically unnecessary power wheelchairs and other durable medical equipment (DME). Meguerian and his co-conspirators then sold the prescriptions to DME supply companies, knowing that the prescriptions were fraudulent. The DME supply companies then submitted the fraudulent prescriptions to Medicare in close to $3.4M in fraudulent claims. 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

August 7, 2014

Margarita Grishkoff, a disbarred Florida attorney, was sentenced to serve 70 months in prison and to pay $14.4 millioin for her role in a $28.3 million Medicare fraud scheme involving false claims for physical and occupational therapy services. Grishkoff admitted as part of her guilty plea that she and her co-conspirators submitted approximately $28.3 million in fraudulent reimbursement claims to Medicare through physical therapy clinics throughout Florida from 2005 through 2009. Medicare paid approximately $14.4 million on those claims. DOJ

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 10, 2014

Four patient recruiters pleaded guilty in connection with a $20M health care fraud scheme involving the now defunct Miami-based home health care agency Trust Care Health Services. The defendants recruited patients for Trust Care and solicited and received kickbacks and bribes from the owners and operators of Trust Care in return for allowing the agency to bill the Medicare program on behalf of the recruited Medicare patients for home health care and therapy services that were not medically necessary and/or not provided. DOJ