Practitioners

February 2007

In Florida, a physician was sentenced to 24 months incarceration and ordered to pay $727,000 in restitution for his involvement in a health care fraud scheme. For cash payments, the physician signed blank prescriptions and certificates of medical necessity for patients he never saw. In turn, co-conspirators submitted claims to Medicare for DME and other items or services that were either not medically necessary or were not provided to beneficiaries.

Home Health Agency

February 2007

In Ohio, the former owner of a home health company was sentenced to 13 years incarceration and ordered to pay $564,000 in restitution for health care fraud, money laundering, and for drug and weapons charges. Investigation revealed that the man solicited a population of the immigrant community to provide unnecessary medical services and billed Medicaid for those services. To facilitate the fraud, doctors signed plans of care to indicate that patients were in need of skilled nursing and home health aid services. In reality, patients had not been seen by the doctors. In addition, reimbursements from claims submitted to Medicaid were diverted to support his drug habit and to fund personal business ventures.

Employee Misconduct

February 2007

In Arizona, a former IHS employee was sentenced to 6 months home confinement and ordered to pay $66,000 in restitution for theft and embezzlement in connection with health care. While employed as a secretary at an IHS medical facility, the man stole checks that were made payable to the Indian Health Service.

Child Support Enforcement

February 2007

In Florida, a woman was ordered to pay a $500 fine for failure to pay child support. Prior to entering her guilty plea, the woman paid her arrearage amount of approximately $40,500. Though she was gainfully employed, the woman had not made a single voluntary child support payment since 1995.