Home Health & Hospice Week

One former owner draws 5-year prison term.

You don’t have to be the mastermind of a home care fraud scheme to get a fraud conviction.

So showed a Feb. 14 federal jury decision in Chicago. According to evidence presented at trial, from 2011 to 2017 Angelita Newton worked at Care Specialists, a home health agency in the city. She was the personal assistant to HHA owners Ferdinand and Ma Luisa Echavia.

Newton conspired with the Echavias to submit claims for medically unnecessary services for ineligible patients, and for visits not provided as billed, the Department of Justice says in a release. Newton created visit notes and other documen­tation for Ferdinand Echavia’s bogus nursing visits, and knew Echavia was making illegal kickback payments to patients, prosecutors showed.

The Echavias and another defendant in the $7 million case, nurse Reginald Onate, have already pleaded guilty to fraud and await sentencing, the DOJ notes. Newton’s sentencing is scheduled for October.

More recent fraud developments include:

In Detroit: A patient recruiter has been sentenced to five years in federal prison after receiving more than $1 million in kickbacks. Dominic Trumbo, owner of Trumbo Consulting Agency of Stafford, Virginia, recruited or paid others to recruit more than 4,000 Medicare beneficiaries for multiple home health companies across the country, the DOJ says in a release. “The evidence showed that Trumbo instructed his employees to cold call Medicare beneficiaries and offer incentives to induce them to sign up for home health care. Trumbo then sold the Medicare beneficiary information to home health agencies in exchange for illegal kickback payments.” Trumbo and his co-conspirators also created sham contracts and fake invoices in an attempt to conceal their fraud scheme, the DOJ says. A federal judge also ordered Trumbo to pay more than $1 million in restitution and forfeit more than $200,000.

In California: Jai Vijay has pleaded guilty to conspiring with the owners of HHAs and a hospice to pay and receive illegal kickbacks, the DOJ says. Jai Vijay’s wife Anita Vijay worked as the social services director at a skilled nursing and assisted living facility, and helped residents select home care and hospice providers upon discharge. Owners of two HHAs in Folsom and El Dorado Hills and a hospice in Folsom paid the Vijays for Anita Vijay to steer about 60 patients to those agencies. Medicare paid the agencies about $400,000 based on the referrals. Jai Vijay is scheduled for sentencing in April.

In Virginia: The former owner of a Portsmouth home care agency has received a one-year federal prison sentence for Medicaid fraud. P&S Home Health Care Solution owner Sandy Varzmanesh, who was an LPN, pleaded guilty last October to forging an RN’s signature on Medicaid paperwork. Varzmanesh, also known as Sandy Vincent, billed Medicaid $764,826 for numerous patients who had not been assessed by RNs and were therefore not eligible for the services provided, reports the Virginian-Pilot newspaper Varzmanesh also collected $98,774 for respite care services that were provided to ineligible Medicaid recipients.

The judge reduced the usual mandatory minimum 2.5-year sentence after Varzmanesh’s attorney argued that while she “skirted eligibility requirements,” her “business nonetheless provided actual services that benefited dozens and dozens of patients,” the Virginian-Pilot says.