Home Health Execs Sentenced In $34 Million Fraud

The owner and medical director from an in-home health provider located in New Orleans were sentenced to prison this week for a $34 million Medicare fraud scheme they took part in.

Elaine Davis, 60, was the owner of Christian Home Health, Inc. and was sentenced to 96 months in prison, and medical director Dr. Pramela Ganji was sentenced to 72 months by Chief U.S. District Judge Kurt D. Engelhardt of the Eastern District of Louisiana, according to the Department of Justice.

Christian Home Health offered home health services around the clock. Their services included skilled nursing, physical therapy, occupation therapy, speech pathology, medical social work and home health aides. The agency is now permanently closed.

Davis and Ganji were both found guilty by a jury on March 17, 2016 of one count of conspiracy to commit health care fraud and one count of health care fraud.

It was found during the investigation and presented as evidence during the trial that Davis orchestrated a huge Medicare fraud scheme by dishonestly billing Medicare for purported home health care services that in many cases did not need to be completed, the DOJ said.

Ganji’s role in the scheme was perpetrated during her time as Christian Home Health’s medical director from 2010 to 2015. Ganji falsely claimed that beneficiaries she had never examined were qualified to receive home health services, evidence showed.

Davis and Ganji billed Medicare claims through Christian Home Health for more than $34.4 million, of which Medicare paid more than $29.6 million, the trial revealed. A large percentage of those claims were found to be fraudulent.

Judge Engelhardt scheduled a restitution hearing for Dec. 7, 2016.

Written by Alana Stramowski