Healthcare Fraud

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

July 7, 2014

Vahe Tahmasian of Glendale, California was sentenced to 121 months in prison and ordered to pay roughly a million dollars for his role in a $1.5M Medicare fraud and identity theft scheme. Tahmasian and his co-conspirators purchased Orthomed Appliance Inc., a DME supply company, stole the personal identifying information of Medicare beneficiaries and doctors in the company’s patient files, and used that information to submit a large volume of fraudulent claims to Medicare. DOJ

June 27, 2014

Euridice Borroto, a patient recruiter for a Miami home health care agency pleaded guilty today in connection with a health care fraud scheme involving defunct home health care company Nestor’s Health Services Inc. The owner and operator of Nestor pleaded guilty to charges related to the scheme earlier this month. According to court documents, Borroto solicited and received kickbacks and bribes from Nestor in return for recruiting and providing patients to Nestor for home health care and therapy services that were medically unnecessary or never provided. Borroto acknowledged her involvement in similar fraudulent schemes at other Miami health care agencies. DOJ

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