Home Health and Hospice Archives

VNS Health: $1M Settlement for Failing To Provide Services to Hospice Patients

Posted 07/3/24

The U.S. Attorney's Office for the Southern District of New York announced a substantial settlement with Visiting Nurse Service of New York (formerly VNSNY, now VNS Health) and its related entities. This settlement addresses allegations of fraudulent billing practices that undermined the Medicaid program meant to support some of the most vulnerable patients like those in hospice. VNS Health is one of the largest...

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

January 5, 2024

A Florida man, Karel Felipe, and Florida woman, Tamara Quicutis, have been sentenced to 8 years and 5 years respectively for their roles in a $93 million fraud scheme against Medicare. Felipe and Quicutis were found guilty last October of submitting claims on behalf of three Michigan-based home health companies, for services never rendered, using stolen patient information, and then laundering the proceeds through dozens of shell companies and hundreds of bank accounts. Their fellow co-conspirators—Jesus Trujillo, Didier Arcia, Alexey Gil, and Jeffrey Avila—have already been sentenced for their roles. DOJ

Tagged in: FCA Federal, Healthcare Fraud, Home Health and Hospice, Medicare, Money Laundering,

Scoundrel Spotlight - Medicare Fraudster Jesus Virlar-Cadena

Posted 10/2/23

This week’s Scoundrel in the Spotlight is Jesus Virlar-Cadena, a former medical director of a Texas-based healthcare provider called Merida Group, who was recently sentenced to over four years in prison in connection with a fraudulent scheme involving over $150 million in false Medicare claims, according to a DOJ press release. The Merida Group marketed hospice services to patients with long-term incurable...

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

August 31, 2023

Watermark Retirement Communities LLC, which manages 79 retirement homes across the country, has agreed to pay $4.25 million to settle claims of violating the Anti-Kickback Statute and False Claims Act. According to a lawsuit launched by David Freeman, the former director of strategic growth for a nationwide home health agency (HHA), between 2014 and 2020, Watermark solicited and received kickbacks from the HHA in exchange for referrals of Medicare beneficiaries from 8 of its retirement facilities in 5 states, including Arizona, Connecticut, Delaware, Florida, and Pennsylvania. Watermark then caused false claims to be submitted in connection with those referrals. DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Home Health and Hospice, Medicare, Whistleblower Case, Whistleblower Rewards,

June 13, 2023

The owner of Grace Healthcare Services, a home health company in Texas, has been sentenced to almost 5 years in prison and ordered to pay almost $1.5 million in restitution for defrauding the state’s Medicaid program. Akintunde Oyewale was convicted of paying illegal kickbacks to medical clinics in exchange for false home health certifications and patient referrals, then billing the Texas Medicaid program for services that were medically unnecessary and not actually provided. TX AG

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

February 7, 2023

United Energy Workers Healthcare, Corp., which provides home health services in multiple states, has paid $9 million to resolve allegations of submitting false claims to the U.S. Department of Labor on behalf of beneficiaries of the Energy Employees Occupational Illness Compensation Program Act (EEOICPA). Multiple whistleblowers alleged that between 2013 and 2021, the defendant and related entities billed for services that were either not covered under EEOICPA program rules, not medically necessary, not provided by appropriately licensed individuals, or not provided entirely. USAO SDOH

Tagged in: FCA Federal, Healthcare Fraud, Home Health and Hospice, Improper Medical Personnel, Lack of Medical Necessity, Other Government Health Programs, Provider Fraud, Whistleblower Case,

December 9, 2022

White Glove Community Care, Inc., a home health agency in Brooklyn, has agreed to pay $1.2 million to the New York Medicaid program and return $2 million in unpaid wages to current and former employees, following a whistleblower’s lawsuit under the state and federal False Claims Acts. A joint investigation by the NY AG and EDNY found that between 2012 and 2018, White Glove failed to pay its home health and personal care aides wages and benefits owed to them under the state’s Wage Parity Act, yet sought and received funds from the state’s Medicaid program for the full wages and benefits owed. AG NY; USAO EDNY

Tagged in: FCA Federal, FCA State, Healthcare Fraud, Home Health and Hospice, Medicaid, Whistleblower Case,

October 14, 2022

The owners of two Texas-based home health clinics have been sentenced to 10 years in prison each after a jury convicted them of conspiring to commit healthcare fraud. Alfred Olotin Alatan, who owned Colony Home Health Services, and Francis Ekene, who owned Milten Medical Clinic, allegedly paid recruiters for patient information, then billed providers for home health services, regardless of need. Co-conspirators Susana Bermudez and Rita Kpotie Smith, both of whom operated the clinics under Alatan’s direction, are currently serving 2.5 years and 5 years in prison, respectively. USAO SDTX

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

September 30, 2022

The owners and operators of three home health care companies in Illinois, Patricia and Felix Omorogbe, have been sentenced to a combined 3.5 years in prison and ordered to pay a combined $8 million in restitution for paying illegal kickbacks to patient marketers in exchange for referrals of Medicare beneficiaries. According to the DOJ, in addition to the kickbacks, Patricia Omorogbe, a registered nurse, also falsely certified that she performed assessments on patients, causing false claims to be submitted to Medicare. DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Home Health and Hospice, Medicare, Provider Fraud,

August 10, 2022

American Senior Communities, L.L.C., will pay over $5.5 million for violating the False Claims Act by charging Medicare directly for hospice services that should have already been covered by the beneficiaries’ Medicare hospice coverage. The fraudulent billing practice was exposed in a whistleblower complaint filed by a former employee of a hospice services provider that worked with ASC. The whistleblower is entitled to receive between 15 and 25% of the recovery. USAO SDIN

Tagged in: FCA Federal, Healthcare Fraud, Home Health and Hospice, Medicare, SNF, Whistleblower Rewards,

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