Home Health & Hospice Week

Another guilty plea has come out of the $13.8 million fraud case against Detroit-area HHAs Physicians Choice Home Health Care, Quantum Home Care Inc., First Care Home Health Care and Moonlite Home Care Inc.

Nabeel Shaikh purported to be a physical therapy assistant with a limited license who provided PT services to homebound Medicare beneficiaries, but Shaikh had a forged PTA degree and no medical license, the Department of Justice says in a release. Shaikh was paid to falsify medical documentation for Physicians Choice and Quantum, which billed and received payments from Medicare for home care services that were never rendered.

According to court documents, Shaikh paid kickbacks and bribes to Medicare beneficiaries to obtain the benes' Medicare information, which was then used to bill Medicare for home health services that were never provided. Shaikh created evaluations, therapy revisit notes, and other documentation memorializing purported PT for patients he did not see or treat. Shaikh also had Medicare benes pre-sign forms and visit sheets that were later falsified to make it appear that the beneficiaries had received home health services when, in fact, they had not, prosecutors say. From 2009 to 2011, Medicare paid more than $900,000 to Physicians Choice and Quantum for fraudulent claims based on falsified files and notes signed by Shaikh.

Shaikh faces up to 10 years in prison and a $250,000 fine at sentencing. Another PTA, a physician, and two agency co-owners have pled guilty in the scheme as well.