Home Care Director Admits Guilt in $45 Million Fraud Scheme

A former home health care executive has pleaded guilty for her part in a fraud scheme worth $45 million that involved falsifying medical records of Medicare beneficiaries. Avelina Fiel, the former director of nursing of Illinois-based Pathways Home Health Services LLC, pled guilty this week to a single count of conspiracy to commit health care […]

Editor’s Picks: Fraud, Fraud, Fraud

This week, Home Health Care News readers read up on three main topics: reimbursement, coding and fraud. The Medicare Fraud Strike Force charged about 300 people—including some in the home health industry—in a variety of schemes that involved more than $900 million in fraudulent health care billings, and the Office of the Inspector General identified […]

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 […]

Physician Indicted in $20 Million Home Health Scam

A Miami physician was indicted as part of a $20 million Medicare fraud conspiracy that already has found one home health operator sentenced to prison. Henry Lora, 51, was charged with two counts of fraud on allegations that the part owner and operator of a Miami-area clinic wrote prescriptions for home health care and other services for […]

Medicare Fraud Sweep Nets $223 Million, 89 Arrests for False Billings

A nationwide takedown by Medicare Fraud Strike Force operations in eight cities has resulted in 89 arrests for alleged participation in Medicare fraud schemes involving $223 million in false billing, the Department of Health and Human Services (HHS) announced Wednesday. The cumulative arrests represented the sixth national Medicare fraud takedown in the Strike Force’s history, […]

Former Miami Vice Actor Charged in Home Health Fraud

Roberto Marrero made his acting debut as a drug dealer named De La Carte in an episode of Miami Vice. Now, the former actor, director and producer of mostly spanish soap operas has found himself in hot water with the federal government for his part in a home health fraud scheme. Marrero and his wife, […]

Industry Leaders Called to Zero-In on Suspected Home Health Fraud

On the heels of an announcement yesterday that nearly 100 individuals have defrauded the government for $223 million in Medicare fraud, home health leaders are calling for a more targeted approach to zero-in on suspected areas within their industry. “The government’s own data show that abusive billing practices in home health occur in isolated parts […]