Home Health & Hospice Week

Authorities have COVID-related fraud in their crosshairs, but that doesn’t mean non-COVID fraud is getting a pass.

On Sept. 17, the Department of Justice announced “criminal charges against 138 defendants, including 42 doctors, nurses, and other licensed medical professionals, in 31 federal districts across the United States for their alleged participation in various health care fraud schemes that resulted in approximately $1.4 billion in alleged losses,” the DOJ says in a release.

The bulk of the fraud was caused by telemedicine at an alleged $1.1 billion amount. COVID-19 healthcare fraud, in contrast, clocked in at $29 million, according to Justice.

Among the COVID fraudsters were “five defendants who allegedly engaged in the misuse of Provider Relief Fund monies,” DOJ notes in the release. “The defendants allegedly used the moneys for their own personal expenses, including for gambling at a Las Vegas casino and paying a luxury car dealership.”

And in Miami, a hospital supplies department worker is accused of stealing N95 masks and other medical supplies from Mount Sinai Hospital and selling them to various purchasers in the first eight months of the pandemic. Among other items, Rickey Delancey Jr. sold $55,000 worth of stolen masks to a purchaser in California, says the indictment. “As a result of the thefts, during the height of the COVID-19 pandemic, Mount Sinai did not have the supplies needed for nurses, doctors, staff, and patients, and at one point was down to only a three-day supply of N95 masks,” the U.S. Attorney’s Office for the Southern District of Florida says in a separate release.

As usual, traditional home health-related fraud was also on the feds’ hit list. Doctor’s office manager Greisy Rosario Varona Docasal is charged with accepting kickbacks in exchange for patient referrals, the Florida release says. Varona Docasal “was involved in a scheme to illegally recruit Medicare beneficiaries and refer them to home health agencies in exchange for receiving illegal kickbacks from the owners and operators of the home health agencies who in turn billed Medicare for home health services for the recruited Medicare beneficiaries,” according to the U.S. Attorney.

Likewise, Mayra De La Paz participated in a conspiracy to solicit and receive kickback payments for the referral of Medicare beneficiaries to an HHA, prosecutors allege.