Home Health & Hospice Week

Plus: Crackdown on state personal care services fraudsters continues

A home health agency owner is one of the fraudsters swept up in the feds’ recent “COVID-19 Health Care Fraud Takedown.”

In May, the HHS Office of Inspector General and law enforcement partners “participated in the largest coordinated law enforcement action to combat health care fraud related to COVID-19,” the OIG says in a release. In all, “14 defendants in seven federal districts across the United States were charged for their alleged participation in various health care fraud schemes that exploited the COVID-19 pandemic and resulted in over $143 million in false billings,” the OIG says.

In Los Angeles, the feds charged Hollywood Home Health Services Inc. owner Petros Hannesyan with “the theft of government property and wire fraud in connection with $229,454 that he obtained from COVID-19 relief programs,” the Department of Justice says in a separate release. Hannesyan “allegedly misappropriated funds from the CARES Act Provider Relief Fund and submitted false loan applications and a false loan agreement to the Economic Injury Disaster Loan Program, rather than use the funds for COVID-19 patient care and to support small businesses experiencing disruption due to the COVID-19 pandemic,” the DOJ says.

The Centers for Medicare & Medicaid Services also “took adverse administrative actions against over 50 medical providers for their involvement in health care fraud schemes relating to COVID-19 or abuse of CMS programs that were designed to encourage access to medical care during the pandemic,” the DOJ relates.

For example: Multiple providers administered COVID-19 tests, then “misused the information and samples to submit claims to Medicare for unrelated, medically unnecessary, and far more expensive laboratory tests, including cancer genetic testing, allergy testing, and respiratory pathogen panel tests,” the DOJ details. “The proceeds of the fraudulent schemes were allegedly laundered through shell corporations and used to purchase exotic automobiles and luxury real estate.”

Another example: Medical professionals are accused of “exploiting” expanded telehealth policies “by submitting false and fraudulent claims to Medicare for sham telemedicine encounters that did not occur,” the DOJ says. “Medical professionals are alleged to have offered and paid bribes in exchange for the medical professionals’ referral of medically unnecessary testing.”

Justice urges the public to report suspected fraud by contacting the National Center for Disaster Fraud (NCDF) at (866) 720-5721 or filing an online complaint at www.justice.gov/disaster-fraud/webform/ncdf-disaster-complaint-form. “Complaints filed will be reviewed at the NCDF and referred to federal, state, local, or international law enforcement or regulatory agencies for investigation,” the DOJ explains.

“It’s clear fraudsters see the COVID-19 pandemic as a money-making opportunity — creating fraudulent schemes to victimize beneficiaries and steal from federal health care programs,” HHS OIG Deputy Inspector General for Investigations Gary Cantrell says in the OIG release. “Our agency and its law enforcement partners are aggressively and effectively investi­gating these egregious crimes.”