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 […]

Former Amedisys Exec Admits to $7.6 Million Fake Tax Credit

A former executive of Amedisys Inc. (NASDAQ: AMED), one of the nation’s largest home health providers, has admitted to charges that he defrauded the company of more than $7.6 million. David Michael Pitts, 41, pleaded guilty Thursday to one count of wire fraud. Pitts was the vice president of tax for Baton Rouge, Louisiana-based Amedisys […]

Editor’s Picks: The Older Americans Reauthorization Act

“Dearly Beloved, we are gathered here today to get through this thing called life.”  This week, music lovers mourned the loss of Prince, but we kept you up to date on the latest happenings in the home health world. Our readers were interested in what MedPAC had to say about moving closer to a single […]

Jury Finds Doctor Guilty in Largest-Ever Home Health Care Fraud

A Dallas physician and three home health agency owners have been found guilty of committing the nation’s largest home health care fraud involving a single doctor. Jacques Roy, a 58-year-old physician from Rockwall, Texas, and three owners of Texas home health agencies—Cynthia Stiger of Dallas, Wilbert James Veasey, Jr. of Dallas and Charity Eleda of Rowlett—were found […]

Home Health Owner Admits Role in $4 Million Fraud

The former owner and operator of a home health agency in the Detroit area has pleaded guilty to participating in a scheme that defrauded the government of $4 million in Medicare payments. Sentencing for 49-year-old Naseem Minhas is scheduled for Sept. 6, the U.S. Department of Justice announced Monday. Minhas was owner and operator of […]