Medicare Compliance & Reimbursement

Fraudulent home health providers continue to feel the focus of the OIG and Department of Justice. And as this case emphasizes, the feds are leveling harsher sentences and heftier fines.

Myrna Parcon, owner of US Physician Home Visits and related Dallas home health agencies A Good Homehealth, a/k/a “Be Good Healthcare Inc.,” and Essence Home Health, a/k/a “Primary Angel Inc.,” has drawn a 10-year prison sentence for her guilty plea in a nearly $60 million physician practice and home care fraud scheme, the DOJ says in a release. A federal judge also ordered her to pay $51.5 million in restitution.

Parcon concealed her ownership of the HHAs. And “more than 97 percent of USPHV Medicare patients received home health care, whether they needed it or not,” the DOJ says. “The false certifications caused Medicare to pay more than $40 million for fraudulent home health services.” USPHV also upcoded its doc visits, billing “at an alarming rate, generally billing for only the most comprehensive physician exam, and always adding a prolonged service code,” the DOJ says.

Co-defendant physician Noble U. Ezukanma, who was part owner of USPHV, was convicted following a five-day trial in March 2017 and awaits sentencing, the DOJ notes. Co-defendants Oliva Padilla, with whom Parcon formed Essence, and Ben Gaines, from whom Parcon bought A Good through a “straw” buyer, have pleaded guilty to their role in the scheme and are awaiting sentencing, Justice adds. USPHV co-owner and billing supervisor Lita Dejesus pleaded guilty to fraud and was sentenced to 24 months in federal prison and ordered to pay $4.2 million in restitution.

Read the DOJ release at: https://www.justice.gov/usao-ndtx/pr/doctor-owner-multiple-home-health-companies-sentenced-nearly-60-million-medicare-fraud.