Home Health & Hospice Week

Two more cases announced by the feds show why authorities' fraud-fighting efforts in the home care industry are picking up steam.

In California, former home health agency marketer Norma Abapo has been sentenced to serve 60 months in prison for health care fraud and tax violations, notes the Internal Revenue Service.

According to the court documents, from 2001 to 2005 Abapo recruited Medicare beneficiaries with cash and gifts to receive home health services that they did not qualify for. Abapo worked as an independent contractor for Provident Home Health Care Services Inc., Wescove Home Health Services, Datacare Home Health Services Inc., United Life Home Health Inc., and New Star Home Health Care, the IRS notes on its Web site.

Medicare paid more than $3 million to the HHAs for those bogus patients, prosecutors say.

Another bust: In Miami, the feds have indicted eight people in another HHA recruiting scheme. Medicare paid ABC Home Health Care and Florida Home Health Care Providers $11 million and $4 million, respectively, for home care services that weren't provided or necessary from 2007 to 2009, according to a Department of Health and Human Services release.

HHA owners Alejandro Hernandez Quiros and Carlos Castaneda acted as recruiters for the agencies, paying beneficiaries kickbacks to use their Medicare numbers to bill services that weren't provided or medically necessary, prosecutors say. Other HHA employees indicted in the scheme are Gladys Zambrana, Javier Zambrana, Enrique Perez, Vanessa Estrada, Vicenta Tellechea, and Modesto Hidalgo. The court froze the assets of the HHAs, the individuals, and related businesses used to launder fraud proceeds, HHS says.

"This indictment is a powerful example of the ongoing impact of the Medicare Fraud Strike Force," says Assistant Attorney General Lanny A. Breuer. "Through real-time data analysis, the Strike Force is at the forefront of stopping health care fraudsters in their tracks."

Fraud in the home care industry is getting special emphasis from the feds. "Health care fraud schemes in South Florida range from simple billing schemes and fly-by-night durable medical equipment providers, to more sophisticated frauds, including infusion fraud, fraud on the Medicare Advantage Program, and now fraud in the delivery of home health services," says Acting U.S. Attorney Jeffrey H. Sloman.

"Today's arrests demonstrate our vigilance in combating home health fraud by bringing to bear enforcement resources from across government," says HHS Inspector General Daniel Levinson.

"These kickback schemes involving conspiracies between suppliers and beneficiaries divert millions of dollars away from the Medicare beneficiaries who truly need these critical services."

The Medicare Fraud Strike Task Force also recently made scores of arrests for Medicare fraud in Detroit and Miami related to therapy services and infusion clinics.