February 13: The Week That Was in Healthcare Fraud and Legality
A recap of high-profile charges, convictions and sentencing involving healthcare legality ending the week of February 13, 2015.
- The United Stated Department of Justice has put a stop to a number of different high-value healthcare scams and charged, convicted or sentences several physicians, executives and companies. The crimes resulted in multiple millions of dollars in fraud and months in jail.
Here is a roundup of some of the legal dealings from the past week.
Fake doctor sentenced to 17 years in prison
Alejandra Collazo, 43, has been sentenced to 17 years in prison because of several years she spent pretending to be a doctor. She launched the Vortex Medical Center and Management Services with the help of a business partner, who is also a convicted cocaine trafficker.
Through the facility, Collazo used the stolen identities of actual physicians to write 2,200 phony prescription referrals to various home healthcare agencies. In return she was paid kickbacks. The scheme cost Medicare $8.5 million.
“She lived a life of lying, stealing and cheating,” prosecutor Kevin Larsen told U.S. District Judge Federico Moreno, according to the Miami Herald. “She is like a catch-me-if-you-can character. She was holding herself out as a doctor, a nurse and a nurse practitioner.”
Healthcare company guilty of $6.9 million in Medicare scheme
The owner of a Miami home healthcare company plead guilty to a scheme that brought in $6.9 million from Medicare. The company allegedly billed Medicare for services including expensive physical therapy and home health services that were either not medically necessary or not performed at all.
Facility pays $5.63 million for false claims
ResCare Iowa will pay $5.63 million to federal and state services to resolve allegations that it violated the False Claims Act by submitting false home healthcare billings to the Medicare and Medicaid programs. This stems from multiple instances of services provided without the proper documentation.
“Home health agencies that bill Medicare and Medicaid must follow the rules,” said Acting Assistant Attorney General Joyce R. Branda of the Justice Department’s Civil Division. “This settlement demonstrates the Department’s commitment to safeguarding taxpayer dollars and ensuring that they are used to provide medically necessary services to federal health care beneficiaries.”
Ambulance company manager sentenced to 78 months in jail
The general manager of Alpha Ambulance in Southern California, Wesley Kingsbury, was sentenced to 78 months in prison for a Medicare fraud scheme that netted $5.5 million. Kingsbury plead guilty to one count of conspiracy to commit healthcare fraud, one count of conspiracy to obstruct a Medicare audit and one count of making materially false statements to federal law enforcement officers.
The ambulance service provided non-emergency transportation to Medicare beneficiaries, primarily to and from dialysis treatments. The company submitted claims for patients that did not need to be transported by ambulance.
