U.K. Home Care Startup Accused of Posting Fake Reviews Online

Since launching in 2016, U.K. home care startup Cera Care, which pairs patients with in-home caregivers, has locked in more than $4 million in venture funding and garnered widespread praise. But now, it’s being accused of crafting fake reviews online and lying about key health partnerships, Bloomberg Technology reported Thursday. Citing “three people with knowledge of […]

Texas Home Health Care Owners Make OIG’s Most Wanted List

The Office of Inspector General (OIG) has named a former owner of a Texas-based home health care company, Ebong Aloysius Tilong, among its “most wanted fugitives.” Tilong was indicted on charges of conspiracy to commit health care fraud, health care fraud, conspiracy to pay kickbacks, payment of kickbacks and conspiracy to commit money laundering in […]

Fraud Watch: Doctor’s Conviction Overturned

New Orleans Doctor’s Fraud Conviction Overturned A New Orleans-based doctor and owner of a home health care company will likely be released from federal prison after an appeals court overturned the original conviction. Dr. Pamela Ganji and Elaine Davis were convicted of health care fraud and conspiracy to commit health care fraud in 2017. Ganji […]

Texas Mayor Involved in $150 Million Home Health Fraud Scheme

Francisco Pena, mayor of Rio Bravo, Texas, has been indicted alongside three other individuals for his alleged role in a $150 million home health care fraud and money laundering scam, according to a memo released by the U.S. Justice Department. Pena, 82, of Laredo, Texas, was charged in an 11-count indictment with co-conspirators Rodney Mesquias, […]

Fraud Watch: Miami, Detroit Sentencing and Conviction

Two Miami Home Health Agency Owners Sentenced in Separate Fraud Schemes The owner of two Miami home health care agencies, now defunct, has been sentenced to 80 months in prison for her role in a $74 million conspiracy to defraud the Medicare program, the Department of Justice (DOJ) announced in late November. Sila Luis, 59—who pleaded […]

Home Health Owner Gets 80 Years in Prison for Medicare Fraud

The co-owner of a Houston home health agency was sentenced to a lengthy prison sentence for his role in a $13 million Medicare fraud scheme and for filing false tax returns. U.S. District Judge Melinda Harmon of the Southern District of Texas ordered Ebong Tilong, 53, to spend 80 years behind bars, according to the U.S. […]

OIG Notes Uptick in Home Care Medicaid Fraud Enforcement

The federal government is ramping up its efforts to nab perpetrators of Medicaid personal care services (PCS) fraud. A similar trend has been noted in Medicare home health care. Fraud indictments of PCS providers or attendants rose 56% between 2012 and 2015, while convictions increased 33% during that time, according to a new Office of Inspector General (OIG) report. […]

[Updated] $75 Million FCA Settlement is Largest-Ever for a Hospice

The largest for-profit hospice chain in the nation and its parent company have agreed to pay $75 million to resolve false claims allegations for hospice services, the Department of Justice announced. The resolution is the largest amount recovered from a provider of hospice services under the False Claims Act, according to the DOJ. Chemed Corporation (NYSE: […]

Fraud Watch: New Orleans, Massachusetts

Home Health Workers Sentenced in $30 Million Fraud Case Zellisha Dejean, 39, pled guilty to one count of health care fraud, according to the Justice Department. Dejean, along with Verinese Sutton, 64, and Larry Taylor, 69, all of New Orleans, were sentenced for their roles in approximately $30,252,905 in Medicare fraud. The case involved 19 […]

CareCentrix, Cigna Accused of Fraudulent Billing Scheme

Insurance giant Cigna (NYSE: CI) and home health coordination company CareCentrix have been accused of a fraudulent billing scheme, in which beneficiaries were allegedly overcharged for in-home medical equipment. Bloomfield, Connecticut-based Cigna is the fourth-largest U.S. health insurance company, according to Forbes. It contracts with other organizations that offer certain services and products to Cigna […]