Home Health & Hospice Week

South Texas executive’s prison term is outstripped only by his co-conspirator’s.

Telling Medicare beneficiaries they have a terminal illness when they really don’t is one way to wind up in prison for a long period of time.

That’s what Henry McInnis, former CEO of the Merida Health Care Group, a collection of health care entities throughout Texas that provides hospice and health care services, has learned after a federal jury convicted him of fraud, money laundering, and obstruction of justice after a high-profile November 2019 trial.

McInnis “directly oversaw a reprehensible criminal scheme that involved the submission of over $150 million in fraudulent bills, the falsification of patients’ medical records, and the payment of unlawful kickbacks,” Acting Attorney General Nicholas McQuaid says in the release.

Although McInnis worked previously as an electrician, “he acted as the de facto director of nursing for the Merida Group,” the DOJ says. “Witnesses at trial testified McInnis directed employees to admit unqualified patients to hospice and home health, keep unqualified patients on services for long periods of time and fired and reprimanded employees who refused to participate in the scheme.” He also “oversaw and enforced a company-wide practice of falsifying medical records to conceal the scheme,” Justice adds.

McInnis also paid illegal kickbacks to physicians via sham medical director payments and to marketers for high-care-level hospice patients, the DOJ says.

Merida owner Rodney Mesquias was sentenced to 20 years in prison in December (see HCW by AAPC, Vol. XXX, No. 1). Two other co-conspirators have pleaded guilty and are awaiting sentencing, the DOJ says.

“McInnis and his co-conspirator’s reprehensible and deceitful actions to defraud Medicare weren’t without harm: vulnerable beneficiaries were unnecessarily enrolled in hospice care, preventing them from accessing needed curative care,” says OIG Special Agent in Charge Miranda L. Bennett. “With our law enforcement partners, we will continue to investigate those who put ill-gotten profits above the well-being of patients in our health care system,” Bennet says in the release.