Home Health & Hospice Week

Agency co-owner gets 10 years.

The massive fraud scheme masterminded by Dr. Jacques Roy, which sparked Medicare payment suspensions for 78 Dallas-area home health agencies that received a large portion of referrals from Roy and his practice, Medistat, has seen its sentencing chapter close.

Reminder: Roy and Medistat primarily provided home health certifications and performed patient home visits. Dr. Roy allegedly certified or directed the home health certification of more than 11,000 patients from more than 500 HHAs over five years. Many of those were for medically unnecessary services and services never provided as part of a massive $375 million fraud scheme. "Medistat's office included a '485 Department,' essentially a 'boiler room' to affix fraudulent signatures and certifications," the Department of Justice says in a release. Medistat and the HHAs - Apple of Your Eye, Ultimate Care Home Health Services Inc., and Charry Home Care Services Inc. - used patient recruiters for the scheme. (See Eli's HCW, Vol. XXI, No. 9 for more details of the case.)

Apple co-owner and patient recruiter Cynthia Stiger was the last to face sentencing in the case, receiving a 10-year prison sentence and an order to pay $26.3 million in restitution. She was convicted of one count of conspiracy to commit health care fraud in April 2016.

Dr. Roy already received a whopping 35-year prison sentence earlier this year, while three other defendants received 10-year sentences and similar restitution levels as Stiger. Charry owner Charity Eleda received a four-year sentence and an order to pay nearly $400,000 in restitution, and Medistat office manager Teri Sivils received three years' probation and an order to pay -p000more than $885,000 in restitution, the DOJ notes in the release.