A home health nurse has pleaded guilty, in federal court in Boston, in relation to a $100 million home health care kickback scheme.
Last week, Winnie Waruru pleaded guilty to one count of conspiracy to commit health care fraud; one count of health care fraud; one count of conspiracy to pay and receive kickbacks; two counts of making false statements; and one count of making a false statement in a health care matter. Her sentencing is scheduled for Jan. 12, 2023.
Waruru was employed at Arbor Homecare Services LLC, a company partly owned by co-defendant Faith Newton. Waruru and Newton allegedly committed health care fraud and paid kickbacks in order to gain referrals. Newton also allegedly laundered the funds.
Overall, the conspiracy was an attempt to defraud MassHealth and Medicare of at least $100 million. Waruru is responsible for billing MassHealth for over $1.2 million in fake skilled nursing visits.
Newton, Waruru and others did not train staff, billed for home health services that were medically unnecessary – or that they did not provide – and billed for services that were unauthorized.
Newton, Waruru and others formed sham employment relationships with patients and billed for fake visits.
“As alleged in the civil complaint, Newton either directly or through Arbor, targeted particularly vulnerable patients who were low-income, on disability and/or suffering from depression and/or addiction,” the U.S. Attorney’s Office, District of Massachusetts, wrote in a news release.
Waruru faces decades in prison, as the charges of health care fraud and conspiracy to commit health care fraud each come with a sentence of up to 10 years in prison. She is also facing a fine of $250,000 or twice the amount of the funds involved in the laundering. The conspiracy to pay kickbacks comes with a sentence of up to five years in prison, three years of supervised release and a fine of up to $250,000. Making false statements and making false statements in a health care matter each come with a sentence of up to five years in prison.
The federal district court judge will make the final decision regarding sentencing based on the U.S. Sentencing Guidelines and statutes.
Last year, the DOJ opened 831 new criminal health care fraud investigations. Federal prosecutors filed criminal charges in 462 cases involving 741 defendants and 312 defendants were convicted of health care fraud-related crimes.
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