Posts Tagged ‘Health Care Fraud Prevention and Enforcement Action Team (HEAT)’

U.S. Intervenes in False Claims Act Lawsuit Against Fla. Home Health Care Company and Its Owner

July 22, 2013

The government has intervened in a whistleblower lawsuit against A Plus Home Health Care, Inc., a home health care company in Fort Lauderdale, Fla., and its owner, Tracy Nemerofsky, the Justice Department announced today. The government alleges that A Plus offered referring physicians’ spouses sham marketing positions with the company to induce the physicians to refer Medicare patients for home health care services. (more…)

Medicare Fraud Strike Force Charges 89 Individuals for $223M in False Billing

May 15, 2013

medicare fraudAttorney General Eric Holder and Department of Health and Human Services Secretary Kathleen Sebelius announced today that a nationwide takedown by Medicare Fraud Strike Force operations in eight cities has resulted in charges against 89 individuals, including doctors, nurses and other licensed medical professionals, for their alleged participation in Medicare fraud schemes involving approximately $223 million in false billings. Florida accounted for 34 of the arrests made.

This coordinated takedown was the sixth national Medicare fraud takedown in Strike Force history. In total, almost 600 individuals have been charged in connection with schemes involving almost $2 billion in fraudulent billings in these national takedown operations alone. The Medicare Fraud Strike Force operations are part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT), a joint initiative announced in May 2009 between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. (more…)

Miami HHA Patient Recruiter Sentenced to 37 Months $20 Million Fraud Scheme

May 7, 2013

A patient recruiter for a Miami health care company was sentenced today to serve 37 months in prison for his participation in a $20 million Medicare fraud scheme. Manuel Lozano, 65, was sentenced to serve two years of supervised release and ordered to pay $1,851,000 in restitution, jointly and severally with co-conspirators.

In February 2013, Lozano pleaded guilty to one count of conspiracy to receive health care kickbacks. According to court documents, Lozano was a patient recruiter who worked for Serendipity Home Health, a Miami home health care agency that purported to provide home health and therapy services to Medicare beneficiaries. (more…)

HHS Proposal Would Increase Rewards to Seniors for Reporting Fraud

April 24, 2013

Health and Human Services Secretary Kathleen Sebelius today announced a proposed rule that would increase rewards paid to Medicare beneficiaries and others whose tips about suspected fraud lead to the successful recovery of funds to as high as $9.9 million. In addition, a new funding opportunity released this month supports the expansion of Senior Medicare Patrol (SMP) activities to educate Medicare beneficiaries on how to prevent, detect and report Medicare fraud, waste and abuse. (more…)

Spotlight Houston: Home Health Care Firms Breaking Rules, Raking in Medicare Dollars

February 12, 2013

By Terri Langford, Houston Chronicle

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The nation’s Medicare program has dished out $1.25 billion for home-based health care in Houston over four years – and yet nearly every agency that provides nurses, therapists and drugs for the elderly and disabled has violated state and federal standards, a Houston Chronicle investigation has found.

Still, little stops the flow of taxpayer dollars to the nearly 470 companies based in America’s fourth largest city. (more…)

Owners of Two Miami Home Care Agencies Plead Guilty in $48 Million Fraud Scheme

December 20, 2012

The owners and operators of two Miami health care agencies pleaded guilty today for their participation in a $48 million home health Medicare fraud scheme. Rogelio Rodriguez, 43, and Raymond Aday, 48, each pleaded guilty to one count of conspiracy to commit health care fraud.

According to court documents, Rodriguez was the owner of both Caring Nurse Home Health Corp. and Good Quality Home Health Inc., and Aday was a manager at Caring Nurse and owner of Good Quality. (more…)

Houston Doctor Convicted for Home Health Medicare Fraud

December 14, 2012

medicare fraudA federal jury in Houston this week convicted Dr. Ben Harris Echols, 63, of Houston, for conspiring to commit health care fraud by falsifying plans of care for Medicare beneficiaries, including patients whom he did not treat. After a four day trial, the jury convicted Dr. Echols of one count of conspiracy to commit health care fraud and six counts of false statements relating to health care matters.

According to evidence, Dr. Echols signed plans of care for Medicare beneficiaries so that fraudulent claims could be billed by Family Healthcare Group Inc. and Houston Compassionate Care. Echols would sign plans of care for Medicare beneficiaries who were not under his care and about whose conditions he had no knowledge. In many instances, the evidence showed, Echols would sign plans of care even though other doctors were listed as the attending physician on the documents. (more…)

Owner of Miami HHA Sentenced to 10 Years in Prison for $42 Million Fraud Scheme

October 16, 2012
The owner and operator of a Miami health care agency was sentenced this week to 120 months in prison for his participation in a $42 million home health Medicare fraud scheme.

Eulises Escalona, 44, of Monroe County, Fla., was sentenced to prison and ordered to pay $26.5 million in restitution. (more…)

Medicare Fraud Strike Force Charges 91 Individuals for $430 Million in False Billing

October 4, 2012

Indictments Include $230 Million in Home Health Fraud; Miami Agency Charged for Fraudulently Billing Medicare $74 Million

By publishing announcements about home health fraud, HCAF demonstrates its commitment to honest providers throughout the state by shining a spotlight on the dishonest providers, eager to provide hope and validation to the good and send a message to the bad actors that their days are numbered.

Medicare Fraud Strike Force operations in seven cities have led to charges against 91 individuals – including doctors, nurses and other licensed medical professionals – for their alleged participation in Medicare fraud schemes involving approximately $429.2 million in false billing, Attorney General Eric Holder and Health and Human Services (HHS) Secretary Kathleen Sebelius announced today.

“Today’s enforcement actions reveal an alarming and unacceptable trend of individuals attempting to exploit federal health care programs to steal billions in taxpayer dollars for personal gain,” said Attorney General Holder. “Such activities not only siphon precious taxpayer resources, drive up health care costs, and jeopardize the strength of the Medicare program – they also disproportionately victimize the most vulnerable members of society, including elderly, disabled and impoverished Americans.” (more…)

Owner of Miami Home Health Company Pleads Guilty in $60 Million Health Care Fraud Scheme

August 15, 2012

The owner of a Miami health care agency pleaded guilty this week for his participation in a $60 million home health Medicare fraud scheme, announced the Department of Justice, the FBI and the Department of Health and Human Services.

Rodolfo Nieto Jr., 40, of Miami, pleaded guilty before U.S. District Judge Cecilia M. Altonaga in the Southern District of Florida to one count of conspiracy to defraud the United States and to receive health care kickbacks. (more…)