Medicare
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April 11, 2016
Naseem Minhas, the owner and operator of Detroit-area home health care agency TriCounty Home Care Services Inc. pleaded guilty today for his participation in a $4 million health care fraud scheme. According to admissions made as part of his plea agreement, Minhas paid a physician and recruiters to refer Medicare beneficiaries to TriCounty and sign medical documents falsely certifying that they required home health care. Minhas, a licensed physical therapist, also admitted that he assisted in creating fake patient files to make it appear as though the patients needed and received services that were unnecessary or not provided. DOJMarch 25, 2016
Damian Mayol, the president of Miami-based transportation company Transportation Services Providers Inc. was sentenced to 60 months in prison and to pay $26.8 million in restitution (and forfeit the same amount) for his role in a health care fraud scheme involving three mental health centers that resulted in the submission of approximately $70 million in false Medicare claims. According to evidence presented at trial, Mayol and his co-conspirators used his company to coordinate the payment of illegal kickbacks to recruiters, who in return referred patients to three now-defunct community mental health centers -- R&S Community Mental Health Inc., St. Theresa Community Mental Health Center Inc. and New Day Community Mental Health Center LLC -- for costly partial hospitalization program services that were not medically necessary or not actually provided. DOJMarch 21, 2016
Florida audiologist Terri L. Schneider was sentenced to 94 months in prison and to pay $2.5 million in restitution for her role in a multimillion-dollar health care fraud and money laundering scheme. According to evidence presented at trial, Schneider and her co-conspirators used three purported medical clinics in Florida -- Cornerstone Health Specialists, Summit Health Specialists and Coastal Health Specialists -- to submit approximately $12.3 million in false Medicare claims seeking reimbursement for radiology, audiology, cardiology and neurology services. The evidence showed that Schneider and her co-conspirators used forged and falsified documents in the Medicare enrollment process for the medical clinics that they operated under false pretenses, and billed Medicare for services that had not been rendered by physicians. They also paid illegal kickbacks in exchange for access to Medicare patients and Medicare patient information used in the fraud scheme. DOJMarch 18, 2016
A federal jury in New Orleans convicted Elaine Davis and Dr. Pramela Ganji for their roles in a $34 million Medicare fraud scheme. The jury found that Davis, who owned Christian Home Health Care Inc., together with Ganji caused the healthcare company to bill Medicare for home health care services that were not needed and/or not actually provided. Davis paid employees to recruit new patients and then sent their Medicare information to doctors, including Ganji, to obtain their signatures to certify that the patients qualified to receive home health care services, which trial evidence showed they did not qualify for or need. DOJMarch 17, 2016
Carlos Medina, owner of Miami-area medical clinics Doral Community Clinic Inc. and Advanced Medical of Doral Inc. was sentenced to 82 months in prison for his role in a Medicare fraud scheme that caused more than $3 million in losses. The clinics purportedly provided medically necessary services to Medicare beneficiaries, but in reality charged cash kickbacks in exchange for prescriptions for home health care services. Some of the beneficiaries who frequented the clinics did not meet Medicare’s criteria for the prescribed services and some of the services prescribed by the medical professionals at Doral and Advanced Medical were never provided by the home health agencies to which the patients were referred. DOJMarch 2, 2016
Mark T. Conklin, the former owner and operator of Florida-based Recovery Home Care Inc. and Recovery Home Care Services Inc. (RHC) agreed to pay $1.75 million to resolve charges of violating the False Claims Act by paying illegal kickbacks to doctors who agreed to refer Medicare patients to RHC for home health care services. Conklin sold RHC to National Home Care Holdings in October 2012. According to the government, Conklin ran a scheme under which RHC paid dozens of physicians thousands of dollars per month to serve as sham medical directors who performed little or no work in exchange for referring their patients to RHC. The allegations originated in a whistleblower lawsuit filed by former RHC employee Gregory Simony under the qui tam provisions of the False Claims Act. He will receive a whistleblower award of up to $315,000 from the proceeds of the government's recovery. DOJMarch 1, 2016
Ubert Guillermo Rodriguez, president and owner of Florida-based durable equipment provider G.R. Services Equipment & Supplies Inc., pleaded guilty to conspiracy to commit health care fraud. According to the government, Rodriguez’s company submitted approximately $2.6 million worth of claims to Medicare seeking reimbursement for durable medical equipment, such as wound care supplies, that was not legitimately prescribed by doctors and was not provided to beneficiaries. DOJDOJ Catch of the Week -- Olympus Corp.
Posted 03/4/16
By the C|C Whistleblower Lawyer Team
This week's Department of Justice "Catch of the Week" goes to Olympus Corp. of America, the country's largest distributor of endoscopes and related equipment. On Tuesday, the company agreed to pay $623.2 million to resolve criminal charges and civil claims for the company's violations of the False Claims Act and Anti-Kickback Statute through a scheme to pay kickbacks to...