An indictment was unsealed on Wednesday in Brooklyn, New York, charging eight defendants with allegedly scheming to defraud Medicaid of approximately $68 million. This was done through the operation of two social adult day care organizations and a home care financial intermediary that paid kickbacks and bribes for services not provided. According to court documents, […]
Category: Fraud
This week, New York Attorney General Letitia James and U.S. Attorney for the Eastern District of New York Breon Peace announced a $17.25 million settlement had been reached with two Brooklyn-based home care agencies for allegedly defrauding Medicaid and underpaying thousands of workers. Specifically, Edison Home Health Care of New York and Preferred Home Healthcare […]
A Detroit-area couple who owned home health care companies was sentenced to prison last week for Medicare fraud and tax evasion, according to U.S. Attorney Dawn Ison. Noli and Isabel Tcruz of Washington Township, Michigan, were sentenced on Sept. 4. Noli Tcruz received six years in prison, and his wife was given three years and […]
A home health owner has agreed to pay about $4.5 million to resolve allegations related to False Claims Act violations. Specifically, the owner – who operated multiple agencies – allegedly provided illegal kickbacks to assisted living facilities and physicians in exchange for referrals. Guardian Health Care, Gem City Home Care and Care Connection of Cincinnati […]
The former owner of a home-based care company – based in the Cincinnati area – has been found guilty of fraudulently billing more than $8.5 million from Medicare, Medicaid and Veterans Affairs (VA) over a six-year period. From 2015 to 2021, Sharon Romaine Ward submitted at least 92,770 claims on behalf of Halo Home Healthcare […]
U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra fielded questions in a House Ways & Means committee hearing on Capitol Hill Wednesday, a few of which were pointed at concerns around potential fraud in home health. Rep. Michelle Steel (R-Calif.) grilled the secretary about an apparent lack of progress on curbing certifications […]
As at-home care has increasingly become a more popular model for health care, a significant portion of fraud convictions over the last 10 years have involved personal care services attendants. Between 2014 and 2023, personal care services accounted for at least 34% of fraud convictions in some years and as much as 48% in other […]
A home health agency has agreed to pay nearly $10 million to settle allegations that it submitted false claims to a health care program for Department of Energy workers. The Wisconsin-based Atlantic Home Health Care (AHH) is a home health care agency that operates in nine states. The U.S. government alleges that in Arizona, between […]
Insurance giant Cigna (NYSE: CI) has reached an agreement with the U.S. government over claims it overcharged the Medicare Advantage (MA) program by misrepresenting patients’ conditions. As part of the agreement, Cigna will pay more than $172 million to the government and will also enter into a corporate integrity agreement with the U.S. Department of […]
A man and woman in Florida were convicted for their roles in a conspiracy to defraud Medicare by billing over $93 million for home health therapy services that were never provided. The conviction was brought down by a federal jury in Miami this week. The two people convicted — Karel Felipe and Tamara Quicutis — […]
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