Three additional home health agency owners have been sentenced to a combined 117 months in prison for their roles in multi-million dollar fraud schemes.
The recent sentencings bring April’s home health-related fraud cases to at least five overall, a total that broadly reflects the increased scrutiny and oversight the industry currently faces.
On April 22, the U.S. Department of Justice (DOJ) announced that the owner of a West Bloomfield, Michigan-based home health agency was sentenced to 84 months in prison for his role in an $8.3 million scheme to defraud Medicare. In addition to his prison sentence, Zahir Shah was also ordered to pay more than $ 8.3 million in restitution.
Shah was found guilty of one count of conspiracy to commit health care fraud and wire fraud, and one count of conspiracy to pay and receive health care kickbacks.
According to evidence presented at his trial, from 2007 to 2017, Shah submitted false certifications to enroll and stay enrolled as a Medicare provider. Additionally, Shah allegedly paid illegal kickbacks to recruiters in exchange for Medicare beneficiary referrals and billed Medicare for claims from these referrals.
Meanwhile, on April 18, DOJ announced that a former medical doctor and his business partner were sentenced to 33 months in prison for their roles in a $7.1 million Medicare fraud scheme that took place in three Las Vegas hospice and home health care agencies. On top of their prison time, Camilo Q. Primero and Aurora S. Beltran were each sentenced to three years of supervised release and ordered to pay restitution of more than $2.4 million.
Primero — a former doctor and owner of Las Vegas-based Angel Eye Hospice, Vision Home Health Care and Advent Hospice — and his business partner, Beltran, were determined to have received $7.1 million from Medicare by filing false enrollment documents.
The false documents, according to DOJ, allowed Primero to operate hospice and home care agencies even though he had been previously excluded from all federal health care programs.
Additionally, Primero and Beltran allegedly submitted false hospice care claims for people who didn’t require care. The two have prior convictions in California state court for defrauding the state’s insurance system.
Since its formation in March 2007, the Medicare Fraud Strike Force, which maintains 14 strike forces operating in 23 districts, has charged nearly 4,000 defendants who have collectively billed the Medicare program for more than $14 billion.
Last month, the Office of Inspector General (OIG) in its fiscal year 2020 budget asked for an extra $10 million in funding to specifically combat fraud, waste and abuse by home- and community-based service providers.