The owner of a home health agency in Dallas pleaded guilty for alleged participation in Medicare fraud schemes that resulted in more that $40 million in fraudulent home health services, the Department of Justice (DOJ) announced.
The scheme involved multiple people who were charged last year as part of a nationwide sweep by the Medicare Fraud Strike Force. Myrna “Merna” S. Parcon, 63, pleaded guilty to one count of conspiracy to commit health care fraud, and faces up to 10 years in federal prison, according to the DOJ. She also faces a fine of up to $250,000 or twice the pecuniary gain to the defendant or loss to the victim, and restitution could also be ordered.
Parcon and five other defendants allegedly conspired to defraud Medicare “by making materially false and fraudulent representations in connection with health care services, namely physician house call visits and home health care,” according to the DOJ.
Parcon was the owner and operator of US Physician Home Visits (USPHV), which provided physician home visits to Medicare beneficiaries in Dallas, as well as certifying and decertifying Medicare beneficiaries for home health visits and providing medication to Medicare patients.
Two of Parcon’s co-defendent—Oliva A. Padilla, 57, of Garland, Texas, and Ben P. Gaines, 56, of Plano, Texas—also pleaded guilty to a conspiracy count. They both face a maximum statutory penalty of five years in federal prison and a $250,000 fine. To other co-defendents—Ransome N. Entindi, 56, of Waxachie, Texas, and Lita S. Dejesus, 70, Allen, Texas—pleaded guilty earlier this year.
The final defendant, Noble U. Ezukanma, 57, a physician from Fort Worth, has to pleaded guilty and is set to go to trial in January 2017.
Parcon also purchased or formed two other home health agencies. All three companies allegedly shared beneficiaries and employees.
“While the three companies appeard to be set up as three separate entities, the companies worked as one,” according to the DOJ. “The same employees often worked for all three companies and were often paid by all three companies. Had Medicare known about the improper relationship and true nature of the businesses, that is, the companies shared almost all of their beneficiaries, these companies would not have been allowed to enroll in the program and bill for services.”
USPHV allegedly submitted billings for fraudulent claims for services not rendered. The home health company also submitted claims as if Ezukanma or Etindi provided services to bill for a higher reimbursement rate for physician home health visits, regardless of who actually did perform the services. Ezukanma and Etindi also certified home heath services for Medicare beneficiaries even if they were ineligible to receive the benefits.
Written by Amy Baxter