Massachusetts Doctor Pleads Guilty in $27 Million Home Health Scheme

A Boston-area doctor pleaded guilty this week for his role in a home health fraud scheme that allegedly bilked Medicare out of more than $27 million.

Dr. Spencer Wilking, former Medical Director for Waltham, Mass.-based MJG Management Company, which operated as At Home VNA, faces a maximum penalty of 10 years in prison plus supervised release and repayment to Medicare for his participation in the scheme. 

According to the Department of Justice, from April 2011 through March 2012, Wilking signed certifications and decertifications to provide At Home VNA home health series to hundreds of Medicare beneficiaries who did not qualify for Medicare-covered services. Under law, doctors must verify eligibility through face-to-face encounters with patients; these encounters were not conducted by Wilking, however. 

Typically, Wilking certified services following minimal time spent reviewing patient assessment forms or after discussing patients’ conditions with nurses or the company’s clinical director, Janice Troisi. 

While many patient files documented the fact the patients were not homebound, Wilking proceeded to certify their home health services, available only to those who are homebound. 

At Home VNA owner Michael Galatis and the Troisi have been charged with conspiracy to commit health care fraud and 11 counts of health care fraud; Galatis as also charged with seven counts of money laundering. They pleaded not guilty to the charges. 

Over the course of the scheme, the company submitted more than $27 million in false and fraudulent claims to Medicare, the DOJ found. 

Sentencing for Wilking is scheduled for May 20.

Written by Elizabeth Ecker

Elizabeth Ecker on EmailElizabeth Ecker on Linkedin
Elizabeth Ecker
Director of Content at Home Health Care News
Curious about all things, when not writing about senior housing topics, Liz is an avid explorer of food. She loves trying new recipes, new restaurants and new ice cream flavors. (Current favorite: Goat cheese with red cherries.)

By continuing to use the site, you agree to the use of cookies. More Information

The cookie settings on this website are set to "allow cookies" to give you the best browsing experience possible. If you continue to use this website without changing your cookie settings or you click "Accept" below then you are consenting to this. For more information, see our cookie policy