Home Health & Hospice Week

Kickbacks, patient recruiters feature heavily in indictments.

If you’re wondering why the moratorium on new home health agencies persists in Texas, a perusal of recent federal fraud cases may tell you.

Case #1: The feds indicated and arrested the owners, the director of nursing and patient recruiters of a home health agency based in Houston, the Department of Justice says in a release. Owners Ebong Tilong and Marie Neba paid kickbacks to physicians for certification of ineligible patients and to recruiters Daisy Carter and Connie Ray Island for referrals. All four paid beneficiaries kickbacks, according to the indictment. Neba, serving as DON, also falsified medical records to support the false claims.

Case #2: Officials indicted 12 patient recruiters in a purported scam at Three Angels Home Health Inc. in Tyler. According to the DOJ, Three Angels paid the defendants $500 per patient they signed up for home care, and they in turn paid beneficiaries $100 to $200 to participate. The scheme that ran from 2012 to 2014 aimed to bilk Medicare of $2.5 million. Earlier this year, Three Angels owner Grace Munthali pleaded guilty to related fraud charges and was sentenced to five years in federal prison in September.

Case #3: Home care “marketer” Martha Flores has received a two-year prison sentence after pleading guilty to Medicare fraud some months back (see Eli’s HCW, Vol. XXIV, No. 33). Flores admitted to using the patient information she bought from a doctor’s assistant to create fraudulent referral forms to submit to the numerous home health agencies where she was employed, the FBI says in a release. Flores also admitted that she forged the signatures of physicians on the referral forms and that she received illegal payment for the referrals.

Texas isn’t the only state with recent home care fraud cases, though.

In Washington, D.C.: Spouses Florence and Michael Bikundi, owners of HHA Global Healthcare Inc., have been found guilty by a jury of health care fraud and other charges stemming from an $80 million Medicaid scheme in the District of Columbia, the DOJ says in a release. The Bikundis billed Medicaid for services never provided and used the proceeds to finance a lavish lifestyle, including a $1.3 million home and multiple luxury cars, prosecutors say. Florence Bikundi concealed her Medicaid exclusion and forged documentation. Seven others have pled guilty in the scheme, including family members. Sentencing is set for February.

In New Jersey: The state Division of Consumer Affairs has suspended Precious Hands home health agency for sending uncertified employees into the homes of patients who needed the services of Certified Homemaker-Home Health Aides (CHHA), and falsifying documents it provided to the state, the Division says in the release. Plus, “Precious Hands … listed three individuals, all of whom are registered nurses, as having been its Director of Nursing at various times,” the Division says in a release. “However, each of the individuals has since provided separate, sworn statements to the Division indicating that they were never employed by Precious Hands and did not know that the business was using their name and license information.”

Owner Grace Njenga said she corrected the problems when she was cited in March and plans to appeal, reports NJ.com.