A Massachusetts home nursing agency owner was recently sentenced to 92 months in prison for fraudulently billing millions of dollars of services to Medicare and then laundering the proceeds.
Michael Galatis, 63, of Natick, Mass. was sentenced by the District of Massachusetts to 92 months in prison, three years of supervised release, and ordered to pay a $50,000 fine, $7 million in restitution to Medicare, and to forfeit proceeds of the fraud scheme, including his house, valued at $850,000, according to the Department of Justice.
Galatis was convicted following a 16-day trial in December 2014 of conspiracy to commit health care fraud, 10 counts of health care fraud, and seven counts of money laundering.
Galatis, a registered nurse, owned and operated At Home VNA (AHVNA), a home health agency located in Waltham, Mass. From 2006 to 2012, Galatis allegedly submitted more than $27 million in false and fraudulent home health care claims to Medicare. Medicare paid AHVNA more than $20 million of those fraudulent claims, according to the Department of Justice.
The Medicare program pays for home health services only if the services are medically necessary and the individual is homebound, notes the Department of Justice, adding that Galatis “ignored these requirements and trained AHVNA nurses to recruit healthy individuals with Medicare insurance who lived in large apartment buildings.”
“Galatis held wellness clinics at these buildings where nurses convinced senior citizens to enroll with AHVNA and have a nurse visit them in their home,” the Department of Justice says. “Galatis, and his co-conspirator, trained AHVNA nurses to manipulate the patients’ Medicare assessment forms to make it appear as though the patients qualified for Medicare home health services, when that was often not the case.”
Galatis allegedly paid a physician, Dr. Spencer Wilking, to sign the home health care orders, even though Dr. Wilking did not examine the vast majority of AHVNA’s patients, according to the Department of Justice.
Patients’ primary care physicians allegedly did not refer the patients to AHVNA and were unaware that AHVNA was sending nurses to see their patients in their homes, according to evidence produced at trial.
Janice Troisi, also a registered nurse and the AHVNA clinical director, is scheduled to go to trial on July 27, 2015. Dr. Wilking, who pleaded guilty in February 2014 to health care fraud, is scheduled to be sentenced on Sept. 22, 2015.
Written by Cassandra Dowell