Home Health & Hospice Week

HHA owner receives 6-year sentence, must repay millions.

While you were busy wrapping presents and making sure holiday shifts were covered, the feds were piling up indictments, convictions and prison sentences under their Christmas tree. Take a look at the latest batch of enforcement actions that occurred over the holidays:

In Dallas: The feds have indicted two home health agency co-owners and two nurses in a $13.4 million Medicare fraud scheme. Timely Home Health Services Inc. owner, administrator and LVN Patience Okoroji, owner, DON and RN Usani Ewah, RN Joy Ogwuegbu, and LVN Kingsley Nwanguma paid recruiters for referrals, falsified documentation, and submitted false claims, according to a Department of Justice release. The scheme ran from 2007 to 2015, prosecutors allege. In Boston: Last fall, a federal jury convicted the former clinical director of At Home VNA of fraud and money laundering charges. Now Janice Troisi has been sentenced to three years in prison for billing Medicare for home care services that weren’t medically necessary or furnished, the DOJ says in a release. Troisi and fellow RN and At Home owner Michael Galatis trained VNA nurses to recruit seniors through wellness clinics held at senior residential facilities, then the nurses fudged documentation to make the patients appear homebound and eligible for services. The VNA’s paid medical director signed certifications for the ineligible patients, prosecutors said. Troisi and Galatis ignored requests from patients’ physicians and VNA staff to discontinue seeing patients who didn’t need home care services.

Troisi also received three years’ supervised release. Galatis was convicted in the scheme in 2014 and sentenced to more than seven years in prison (see Eli’s HCW, Vol. XXIV, No. 9). The medical director, SpencerWilking, pled guilty in the scheme in 2014 (see Eli’s HCW, Vol. XXIII, No. 9). Wilking got one year of home confinement and a $7,500 fine, the DOJ notes.

In Texas: A federal jury has convicted RN Florence Kroma of Medicare fraud. From 2008 to 2013, the owner of Mt. Zion Home Health Agency in Denton submitted false claims for home care services which were not provided and not authorized by the patients’ physicians, the DOJ says in a release. Kroma submitted claims for services she allegedly provided when she was out of state and for services she allegedly provided to patients who testified that they did not know her and had never heard of her company.

In Detroit: After pleading guilty to Medicare fraud, the owner of Advance Home Health Care Services Inc. has been sentenced to more than six-and-a-half years in prison and been ordered to pay $4.6 million in restitution, the DOJ says in release. Amer Ehsan conspired with physicians, physical therapists and patient recruiters to bill Medicare for unnecessary home care services and paid co-conspirator physicians to refer Medicare beneficiaries to Advance and sign medical documents falsely certifying that they required home care, the release says. Ehsan also admitted that at his direction, Medicare beneficiaries received cash kickbacks in exchange for signing multiple blank physical therapy records. And he owned and controlled Michigan Rehab and Management Services, which he used to sell information about beneficiaries and corresponding fictitious patient files to other Detroit-area HHAs. Twelve defendants have pled guilty in the “wide-ranging scheme,” the DOJ says.