Catch of the Week: Texas Hospice CEO Gets 13 Year Sentence in $60 Million Fraud Scheme
A federal judge in Texas sentenced Bradley Harris, former head of Novus Health Services, Inc. hospice company in Frisco, to more than thirteen years in prison and ordered him to pay $27.6 million in restitution. The sentence, announced in a DOJ press release, follows his guilty plea on charges of conspiracy and fraud on Medicare and Medicaid.
Harris is the latest to be sentenced in a fraud scheme spanning 2012-2016, exposed in 2017 when a grand jury indicted sixteen individuals. Another ten defendants also pleaded guilty and, three more were convicted at trial. Like Harris, several others received lengthy sentences and hefty fines, including former Novus doctors.
The hospice fraud scheme involved improperly placing ineligible patients in hospice and submitting false claims to the government for the services. Medicare will not cover hospice care unless a qualifying physician certifies the patient is terminally ill, meaning expected to live no more than six months. As part of the plea, Harris admitted two Novus doctors regularly signed off on hospice eligibility without examining the patients, the DOJ explained in the sentencing release.
He also admitted to using health records from a third-party company to recruit new patients for hospice services without regard for their hospice eligibility. This was lucrative for Novus, in part, because it helped the company fall below the “aggregate cap” Medicare and Medicaid sets to limit annual hospice payments to any one hospice in a year. The cap factors in the number of beneficiaries served, so enrolling more patients allowed Novus to keep more money.
The government also accused the various co-conspirators of administering large doses of controlled substances, regardless of whether the patient needed the medication. While Harris did not admit to patient harm, he did admit he used blank prescription pads from Novus doctors to sign off on Schedule II controlled substance prescriptions. Medicare won’t pay for drugs dispensed without a valid prescription.
Even when the government caught on to the scheme and suspended payment to Novus, Harris and his co-conspirators continued the scam, transferring patients to a “new” company staffed by Novus personnel.
Hospice Fraud Harms Patients, Burdens Healthcare System
Hospice fraud and improper billing, including falsely certifying patients for admission, is widespread, costs Medicare hundreds of millions of dollars, and harms patients.
Government prosecutors have repeatedly condemned hospice fraud and pledged continued enforcement in this space. In an earlier release announcing the Novus indictments, U.S. Attorney John Parker said “that tens of millions of dollars were stolen through fraud is shocking enough. That these defendants used human life at its most vulnerable stage as the grist for this scheme displays a shocking level of depravity that this community simply cannot tolerate.”
If you have information about hospice fraud or another type of fraud in healthcare, you could have a whistleblower case under the False Claims Act and you may be eligible for a reward. Contact our team of whistleblower lawyers to learn more.
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