Virginia Home Health Owners Sentenced in $2.1 Million Fraud Scheme

The owners of a Virginia home health care agency were sentenced last week to 121 months in prison for their roles in a health care fraud scheme.

From January 2008 through June 2011, Irvine Johnston King, 46, and Aisha Rashidatu King, 40, of Woodridge, submitted more than $2.1 million in false claims to Virginia Medicaid and Anthem Blue Cross and Blue Shield (BCBS).

The Kings were convicted at trial on January 10, 2013 of conspiracy and multiple counts of health care fraud, including two counts of aggravated identity theft, according to the Federal Bureau of Investigation (FBI).

At sentencing, the Kings were ordered to pay $931,894 in restitution and to forfeit the same amount for having fraudulently billed for reimbursement of services they did not provide.

The Kings owned and operated Bright Beginnings Healthcare Services, a business that provided in-home personal and respite care, as well as private duty nursing services to Medicaid-elligible individuals.

Of the $2.1 million in fraudulent claims, Virginia Medicaid paid out $766,620 and BCBS paid $165,273, the FBI notes.

In May 2009, after learning that Virginia Medicaid had called in an outside firm to audit Bright Beginnings, the Kings began “an extensive effort” to cover up the fraud by creating false nursing documentation to support the claims, according to court documents.

The Kings supervised an unlicensed employee who completed time sheets under the name of a licensed nurse and billed the employee’s time to Virginia Medicaid as licensed practical nursing services.

They also directed the father of a patient to sign blank time sheets, which were then falsified to support fraudulent billing for services that had never been provided to that patient.

The investigation was conducted by FBI’s Washington Field Office and the Virginia Attorney General’s Medicaid Fraud Control Unit, with the assistance of the Virginia Department of Medical Assistance Services.

United States District Judge Claude M. Hilton presided over the case.

Written by Jason Oliva