Home Care Ex-Employee Indicted, Arrested for Home Care Kickbacks and Prescription Fraud

November 13, 2020 | Aging Services Risk Management

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​​Following indictment by a federal grand jury, an ex-employee of a home health agency has been arrested for her involvement in home care kickback schemes and prescription fraud, according to an ​October 16, 2020, news release from the U.S. Department of Justice.

The employee, along with the owner of a medical marketing business, allegedly solicited and received money from pharmacies and laboratories to increase the volume of prescriptions, laboratory analysis, and other billable services. The ex-employee used real patient information to create false prescription forms, using presigned or photocopied forms or forging doctors' signatures. Over nearly five years, the employee created fraudulent prescriptions that were submitted for payment to federal healthcare benefit programs, including Medicare, Medicaid, TRICARE, and the federal employees' benefit program, and to private insurance companies. Once the benefit program or insurance company reimbursed the pharmacies, the pharmacies paid the employee and the marketer a kickback for each prescription. The employee ultimately received more than...

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