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Home Health and Hospice

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November 13, 2019

The Louisiana Department of Health, which manages Louisiana’s Medicaid program, will pay $13.42 million to the federal government to resolve allegations that the state submitted false claims for federal share reimbursement of state Medicaid expenditures for long-term nursing care and hospice care.  The federal government alleged that in anticipation of a reduction in federal payments for such services, the state agency directed its healthcare contractor, Molina Medical Solutions, to pre-bill for nursing home and hospice services in order to receive funds at the existing higher rates.   DOJ

November 5, 2019

A home health agency that allegedly defrauded Medicare and Louisiana’s Medicaid program has agreed to pay $2.5 million to settle claims arising from a qui tam suit.  Defendants Health Care Options, Inc., Health Care Options of Lafayette, Inc., Home Care Options Houston, Inc., and Howard Austin, II allegedly submitted reimbursement claims involving non-face-to-face encounters, as required by program rules.  USAO MDLA

October 28, 2019

Atheir Amarrah, the owner of Michigan-based Prompt Care Home Health Services Inc, has been sentenced to 5 years in prison and ordered to pay $1 million in restitution after pleading guilty to paying recruiters for referrals to Medicare beneficiaries.  In his guilty plea, Amarrah also admitted to billing Medicare for claims tainted by illegal kickbacks.  DOJ

October 17, 2019

Five home health providers in Iowa and South Dakota have been ordered to pay a combined $3.1 million for submitting false claims to Medicare.  Affiliates of Minnesota-based Welcov Healthcare LLC allegedly billed Medicare for therapy services that were not provided by skilled employees or not medically necessary.  Sergeant Bluff Healthcare, LLC will pay over $1.2 million, Logan Healthcare, LLC and Elk Point Healthcare #1, LLC will each pay over $775,000, Red Oak Healthcare, LLC will pay over $228,000, and Flandreau Healthcare 2, LLC will pay about $116,000.  USAO NDIA

Government Documents Dangerous Failures in Hospice-Care Facilities

Posted  07/19/19
By Sarah “Poppy” Alexander
hand holding hospice patients hand
The Department of Health and Human Services (HHS) recently released two deeply concerning reports about failures in hospice care. Hospices put patients in harm’s way by failing to meet Medicare’s standards of care, failing to protect patients from abuse, and failing to report dangerous conditions. All told, the reports paint a grim picture of substandard health services for a particularly vulnerable patient...

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

United States Intervenes in Home Health Care Fraud Case

Posted  05/30/19
Doctor Hand Taking Money from Patient's Hand
Last week, the United States intervened in a lawsuit brought against Florida-based Doctor’s Choice Home Care and its two owners.  The Department of Justice alleged that the company bribed doctors to refer patients in violation of the federal Anti-Kickback Statute and Stark Law. Both laws prohibit medical providers from paying or receiving kickbacks in connection with government-funded health care...

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

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
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