More Reports of ZPIC Activity in Louisiana
In case you weren’t already aware of this, using a ‘recruiter’ to find Medicare patients for a home health agency is fraud, both on the part of the recruiter and the agency. The story below goes into detail regarding a Miami man who was convicted. You can also read about five nurses who were convicted of fraud for falsifying records to defraud Medicare. These activities continue to be aggressively pursued by the US Attorney’s Office and their Health Care Fraud Prevention and Enforcement Action Team (HEAT). You can hear about their efforts, and more from US Attorney Corey Amundsen at HCLA’s Fall Leadership Summit. And healthcare attorney Greg Frost will present information about the fraud, abuse and oversight issues in the new healthcare reform, the Affordable Care Act. The new healthcare reform legislation includes $500 million to root out Medicare Fraud. Also, Julie Agan, head of the Senior Medicare Patrol, will share the latest on the project to train senior citizens on how to identify and report Medicare Fraud in home health. Read on.
A federal jury on Wednesday found a Miami man, who prosecutors say recruited patients as part of a home health fraud scheme, guilty of conspiracy to commit health care fraud and soliciting and receiving kickbacks and bribes.
According to evidence presented at trial, Antonio Ochoa was a patient recruiter and home health aide for ABC Home Health and Florida Home Health Care Providers. The agencies purported to provide physical therapy and home health services to Medicare beneficiaries. Ochoa solicited and received $1,300 per Medicare beneficiary in exchange for referring them to ABC and Florida Home Health, according to evidence presented at trial.
The agencies then billed Medicare for services that were either not necessary or never provided. Ochoa’s partner, Eduardo Romeo, pleaded guilty in July and testified at the trial. Ochoa was one of numerous suspected rounded up last December during a Medicare fraud sweep.
Last month, five nurses, who worked at ABC Home Heath Care and/or Florida Home Health Care, pleaded guilty to their part in the scheme, which authorities say resulted in the filing of millions of dollars in false and fraudulent Medicare claims. Ochoa faces a maximum of 10 years in prison for the conspiracy to commit health care fraud count, and five years in prison for each of the three kickback counts.
Read more: Miami man convicted of Medicare fraud – South Florida Business Journal
