Home Health & Hospice Week

You don’t have to be in a HEAT strike force city to catch the feds’ attention.

It may not be the Medicare fraud laws that get you if you go astray. Alleged banking violations have led to five years in prison for one Lone Star state home health agency owner.

The owner of Joystar Home Health Ser-vices in Richmond was sentenced to serve five years in prison for his leading role in a conspiracy to structure over $1.8 million in bank withdrawals to conceal a $4.5 million healthcare fraud scheme, the De-partment of Justice says in a release. Owner Felix Maduka and Director of Nursing Stella Maduka withdrew just under $10,000 in cash from Joystar bank accounts on nearly 300 occasions to avoid the bank’s mandatory reporting requirements of cash transactions, prosecutors said.

The husband and wife used the cash to pay illegal kickbacks to recruiters in exchange for referring Medicare beneficiaries to Joystar, and to doctors for authorizing home health services that were not medically necessary nor provided. To further conceal the scheme, the Madukas fabricated patient records to support the fraudulent Medicare billing, the DOJ says.

Other recent fraud developments include:

In Miami: Three patient recruiters were sentenced to two-and-a-half and three years in pri-son due to a home care fraud scheme. Estrella Pe-rez, Solchys Perez, and Abigail Aguila recruited patients for home health agency Trust Care, in exchange for kickbacks, according to a DOJ release. Estrella Perez and Solchys Perez also paid kickbacks and bribes to co-conspirators in doctors’ offices and clinics in exchange for home health and therapy prescriptions, plans of care and medical certifications for their recruited patients. The recruiters also must repay millions in restitution.

In New Orleans: A New Orleans grand jury has indicted seven more defendants for their roles in a $56 million Medicare fraud scheme involving multiple home health and durable medical equipment companies in the area, the DOJ says in a release. They join eight individuals already indicted in the scheme. The accused include owners, physicians, office managers, an accountant and a nurse.

Three defendants, including Dr. Alvin Dar-by, have already pled guilty in the case and await sentencing, the DOJ notes. Companies involved include Interlink Health Care Services Inc., Me-morial Home Health Inc., Lakeland Health Care Services Inc., and Lexmark Health Care.

In Detroit: Dr. Vicha Janviriya plead guil-ty to falsifying medical documentation and falsely certifying Medicare beneficiaries as homebound or requiring home care services, the Justice Depart-ment says in a release.

In Ohio: The owners of Mentor-based Just Like Familee have had their houses seized as the FBI closes in with Medicaid fraud charges. Court filings from the U.S. Attorney’s Office say owners Delores Knight and her daughter Theresa Adams used money from the HHA’s bank account to build the two luxury homes, reports the Sun News. Knight and Adams both denied the allegations made in the complaint in a court filing.

Federal agents raided the company’s three locations in January and interviewed at least nine current and former employees. The employees alleged the owners ordered them to fake doctors’ signatures, lie about what services they provided to patients and ask patients to sign fraudulent documents, the filing says. Employees also told investigators that owners directed them to alter records during an audit by the Ohio Department of Health, court records say.

The agency’s own data pointed the way for investigators, the Sun News indicates.

The company charged 80 percent more for services than other home health care providers and ordered more than double the amount of length per stay for patients, according to the filings.

The company allegedly regularly shorted employees paychecks as well.