Home Health Fraud: Small-Time Crooks Get Oversized Sentences

When it comes to prosecuting large corporations and small-time offenders for Medicare fraud in Florida, it’s a “Tale of Two Justices,” writes one Orlando Sentinel columnist is a recent opinion piece.

A discrepancy exists, argues the Sentinel’s Scott Maxwell, between the penalties handed to big-time fraudsters such as hospitals and large nonprofits, compared to smaller perpetrators like home health providers, private nurses and small nursing home operators.

Maxwell lists several instances where smaller offenders are “prosecuted with zeal,” whereas when big companies are accused of similar violations, they are offered breaks.

“The small-time thieves get prison sentences. The big-time thieves get deals,” writes Maxwell.

One example provided by Maxwell was the case of a 49-year-old home health worker from “dirt-poor” Gadsden County who was accused of bilking Florida’s Medicaid program for $13,000. For this crime, the offender was ordered to spend six months in prison and repay all of the money she stole from taxpayers.

To compare the gravity of fraud in the instance of a larger offender, Maxwell notes a case from a few years earlier, where the state accused several hospitals of defrauding the Medicaid system — only this time the amount totaled in the millions.

All Children’s Hospital of St. Petersburg, which was accused of improperly taking $2 million, repaid $100,000, Maxwell noted, citing Florida Today, while Lakeland Regional Memorial, which was accused of taking $1.7 million, paid $108,000.

In another fraud case involving a number of hospitals, Maxwell described a statement issued by the state saying it wanted “to resolve this matter amicably with our industry partners.”

Meanwhile, a Tampa woman recently received a sentence of 18 months imprisonment and an order to repay all of the $70,000 she improperly billed taxpayers for services to a developmentally disabled relative.

“The message seems to be that fraud committed by lone grifters is evil, intentional and criminal,” Maxwell writes. “Corporate fraud, however, is the result of clerical errors and misunderstandings — cases where we should seek solutions that make everyone happy.”

The inequality is not limited to states’ discretion, Maxwell notes, arguing that the federal government also prosecutes just as unequally for health care fraud.

He specifically cites an instance last year in Tampa, when the federal government secured prison sentences of one to three years for three WellCare executives convicted of defrauding taxpayers out of $30 million.

“Interestingly, though, in this case of convicted execs, the judge decided to impose some of the lightest sentences possible, saying the poor men’s reputations had already been damaged so badly that ‘they’ve already been punished,'” writes Maxwell.

Read the Orlando Sentinel Opinion piece.

Written by Jason Oliva