Home Health Care and Medciare Fraud

Louis T. Age owner of South Louisiana Home Health Care who operated the company with Verna Age were sentenced to 180 months and 60 months in prison, respectively, and ordered to forfiet $9.2 million and pay $17.1 million in restitution for their roles in a $17.1 million Medicare fraud scheme involving the payment of kickbacks and falsification of documents.  Louis Age and Verna Age were convicted on one count of conspiracy to commit health care fraud and Mr. Age was convicted of one count of conspiracy to defraud the United States and to pay or receive illegal health care kickbacks.

The Ages paid kickbacks to patient recruiters in exchange for Medicare beneficiary information.  Nurses, including Verna Age, would then falsify qualification documents so it appeared that the beneficiaries qualified for the home health services.  Evidence at trial showed that Louis Age hired and paid doctors kickbacks in exchange for signing fraudulent referrals and certifications for home health services that were not medically necessary.  The Ages also used fraudulently acquired Medicare beneficiary information and false documents to submit claims to Medicare for the medically unnecessary home health services.  From 2005 to 2011, Medicare reimbursed South Louisiana Home Health Care approximately $17.1 million based on these fraudulently submitted claims.

In yet another case of home health care fraud, Hemal Bhagat a greater Detroit area physical therapist employed at Prestige Home Health Services Inc., and co-owner of Royal Home Health Care Inc., plead guilty to one count of conspiracy to commit home health care fraud for his role in a $22 million home health care fraud scheme.

Bhagat and his co-conspirators, from approximately May 2009 through October 2011, paid kickbacks to patient recruiters in exchange for Medicare beneficiary information.  The co-conspirators created fictitious therapy files appearing to document physical therapy services to these beneficiaries, when  such services were not provided and/or were not medically necessary. Bhagat signed the documents in these fictitious therapy files, including physical therapy evaluations, supervisory patient visits, and patient discharge forms, which indicated that he and others had provided physical therapy to the Medicare beneficiaries when in fact they had not.  Bhagat admitted he knew these falsified documents were used to support the false claims that his co-conspirators at Prestige Home Health Services, Inc. and Royal Home Health Care Inc. submitted to Medicare.  During this time frame, Medicare reimbursed these two home health care agencies approximately $4, 767,359.03.

Bhagat awaits his sentencing scheduled for November 12, 2013.

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