Fraud Watch: Diaper Money Laundering Duo Sentenced

Mother-Daughter Duo Sentenced to Decades in Prison for Miami Scheme

A mother and daughter who “secretly” co-owned and operated seven home health care agencies in the Miami area were each sentenced to more than 10 years in prison for their roles in a $20 million Medicare fraud conspiracy, according to the Justice Department. The duo were discovered when they were traveling back to Miami from the Dominican republic with more than $2.4 million in their luggage wrapped in diapers and baby towels.

The conspiracy involved paying illegal kickbacks to patient recruiters and medical professionals in return for Medicare beneficiaries. The mother and daughter co-owners, Mildrey Gonzalez, 61, and Milka Alfaro, 39, failed to disclosed their ownership interest in any of their home health agencies to Medicare, as required. They were sentenced to 135 and 151 months in prison, respectively, and ordered to pay approximately $22,900,000 in joint and several restitution.

Read more about the case here.

Six Found Guilty in Fraudulent ‘House Dcotors’ Billing Scheme

After a four-week trial, six individuals have been found guilty of committing approximately $13 million in Medicare fraud, the Justice Department announced.

The defendants participated in a criminal organization that fraudulently billed Medicare for medically unnecessary home health services for patients who were not homebound. Four of the six, who were known as “House Doctors,” ordered home health services for patients with no medical necessity for them.

Henry Evans, 71, was found guilty of five counts of health care fraud; Michael Jones, 47; Paula Jones, 45; Shelton Barnes, 62; Gregory Molden, 60—all of New Orleans—and Jonathan Nora, 29, of River Ridge, La., were all found guilty of conspiracies to commit health care fraud, defraud the U.S., and receive and pay health care kickbacks, as well as health care fraud.

In return for ordering home health services, Drs. Barnes, Evans, and Molden received monthly payments fraudulently characterized as medical consultant or director fees. The company, Abide, also knowingly scheduled visits with Medicare beneficiaries who were referred by marketers, instead of the beneficiary’s own health care professional.

Ohio Home Health Care Owner Pleads Guilty to $2 Million Fraud

Cheryl McGrath, 49, of Guysvile, Ohio, pleaded guilty to health care fraud and willful failure to pay over tax. McGrath owned and operated Home Health Care of Southeast Ohio in Guysville since 1993.

McGrath executed a scheme to defraud the Ohio Medicaid program from 2009 to 2015 by billing on behalf of her agency for services that were never rendered, according to the Justice Department. In total, her scheme included fraudulent claims in the amount of approximately $2.2 million. From 2009 to 2013, she also did not pay over the federal employment taxes that were due, totaling a $366,825 loss to the IRS.

Health care fraud carries a potential maximum sentence of 10 years in prison, while willful failure to pay over tax is punishable up to five years in prison. McGrath has agreed to pay more than $2.2 million in restitution to the Ohio Medicaid Program and nearly $367,000 to the IRS.

Find out more about the case here.

Mother and Son Sentenced in $8 Million Fraud Scheme

A mother and son were sentenced to prison for an $8 million scheme to fraudulently bill Medicare, Medicaid and the Department of Veterans Affairs (VA).

Delores Knight, 71, of Cleveland Heights, Ohio, was sentenced to 10 years in prison; Isaac Knight, 30, of Macedonia, Ohio, was sentenced to more than seven years in prison.

The Knights, along with three others, ran Just Like Family II Inc. and Just Like Family III Inc., home health care companies with Ohio offices in Cleveland Heights, Twinsburg, and Mentor.

The pair prepared and submitted forged documents to government agencies for services that were never provided, with Delores Knight as the ringleader.

Three other were indicted in the scheme—Sonja Ferrell, the company’s nursing director, pleaded guilty and was sentenced to 18 months in prison; Juliet Bonner, the bookkeeper was placed on home detention for eight months. Both testified again the Knights.

All defendants were ordered to pay back more than $8.1 million.

Read more on Cleveland.com.

Written by Amy Baxter