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 defendants in a 26-count indictment.

Dejean was sentenced to two years probation and $1,690.12 in restitution. Sutton and Taylor were each sentenced to two years probation and a $2,000 fine by U.S. District Judge Susie Morgan.

Dejean worked as an RN for Priority Care at Home, Inc., which did business as Abide Home Care Services, a home health company operated by Lisa Cranel. Dejean’s duties included assessing the status of her patients, initiating a plan of care, evaluating patient needs, providing comprehensive nursing care, among others.

Sutton, who operated two unlicensed group homes that served as residences to Medicare beneficiaries with psychiatric diagnoses, pled guilty to one count of of conspiracy to receive illegal kickbacks in June 2016. Taylor pled guilty to one count of conspiracy to receive illegal kickbacks in June 2016, and was a driver and recruiter in the New Orleans area, who transported patients on behalf of co-defendent, Michael Jones, who was paid by Abide for referring patients.

Crinel, the owner of Abide, was sentenced to 80 months imprisonment, followed by three years of supervised release, and restitution to Medicare in the amount of $16,088,222.

Massachusetts Home Health Agency Charged with $2.7 Million in Medicaid Fraud

Hellen Kiago, 47, of Sturbridge, Massachusetts, was arrested for allegedly overbilling and falsely billing Medicaid for services that weren’t authorized, Boston Business Journal reported. As the owner of Lifestream, Kiago has been charged with defrauding Medicaid out of $2.7 million. Lifestream provides skilled nursing and home health aide visits to MassHealth beneficiaries.

Kiago and Lifestream were indicted on five counts of Medicaid False Claims and one count of larceny over $250 by false pretenses, the Journal reported.

Reportedly, former employees told Attorney General Maura Healey’s office that aides submitted more hours on their timesheet for services than outlined in care plans, and Kiago directed employees to perform more care than medically necessary.

Written by Amy Baxter