Home Health Agency to Pay $1.8 Million For Kickback Scheme

A home health care agency based in Kansas City, Kansas, and its owner have agreed to pay $1.8 million to resolve allegations that they violated the False Claims Act. Reginald King, owner and operator of Best Choice Home Health Care Agency Inc., was alleged to have had a part in paying kickbacks for referrals of […]

Home Health Execs Sentenced In $34 Million Fraud

The owner and medical director from an in-home health provider located in New Orleans were sentenced to prison this week for a $34 million Medicare fraud scheme they took part in. Elaine Davis, 60, was the owner of Christian Home Health, Inc. and was sentenced to 96 months in prison, and medical director Dr. Pramela […]

Investor Lawsuit Against Amedisys Moving Forward

A class action lawsuit against Amedisys Inc. (Nasdaq: AMED) has been allowed to proceed, in part, under a ruling by U.S. District Chief Judge Brian A. Jackson of Louisiana. The suit alleges Amedisys and seven current or former members of Amedisys’s senior management defrauded investors by concealing a Medicare fraud scheme. The particular rule named […]

Editor’s Picks: New Bundled Payment Model

Hold on to your hats, folks! The winds of new regulations are blowing in fast. This week was all about new regulations, as we clue in our readers to the newest bundled payment initiative coming down the pipe from the Centers for Medicare & Medicaid Services. At the same time, home health industry groups were […]

Home Health Agencies Implicated in $1 Billion Medicare Fraud

The Department of Justice has brought charges against the owner of 30 Miami-area health care facilities in the largest single Medicare fraud scheme ever, totaling $1 billion. The owner, Phillip Esformes, 47, was charged with conspiracy, obstruction, money laundering and health care fraud for his role in numerous schemes across the network of facilities, which included […]

It’s Official: False Claims Penalties Will Nearly Double

In the aftermath of a proposal earlier this year to nearly double False Claims Act (FCA) penalties, federal authorities have confirmed the spike will happen by August 1, 2016. The change will bump the minimum penalty for a False Claims Act from $5,500 to $10,781 and increase the maximum penalty from $11,000 to $21,563. FCA […]

Feds Target Home Health in Historic, $900 Million Fraud Bust

The Medicare Fraud Strike Force has engaged in a three-day execution of the largest fraudulent billings takedown—that includes home health agencies—in the group’s history. Approximately 300 people were charged across 36 federal districts for their alleged participation in a variety of schemes that involved more than $900 million in fraudulent health care billings, according to […]

No Witness Needed for Conviction in $9.5 Million Hospice Fraud

The federal government upheld a conviction for one hospice nursing staffer who was part of a $9.5 million Medicare fraud scheme that involved overbilling for hospice services. Seven defendants were convicted earlier this year in the case against Passages Hospice, a now-closed Illinois hospice provider, for a scheme that included falsifying patient records to bilk […]

Husband, Wife Get Prison Time in $80 Million Medicaid Fraud Scheme

The husband-and-wife owners of a Washington, D.C.-area home care agency have been sentenced to 17 years combined in prison for participating in an $80 million Medicaid fraud scheme. Florence Bikundi, 53, and her husband, Michael D. Bikundi Sr., 63, both of Mitchellville, Maryland, were sentenced Wednesday for health care fraud, money laundering and other charges […]

False Claims Penalties Could Double to ‘Eye-Popping’ Figures

Penalties under the False Claims Act (FCA) are set to nearly double to “eye-popping” numbers, if a proposed regulation becomes effective. The penalty hikes could help discourage home health companies and other health care providers from committing Medicare fraud. However, providers may argue that current penalty levels are already sufficiently punitive, furthering the ongoing discussion […]