In the Courts: Home Care Agency Owner Sentenced to 7.5 Years in Prison for Medicare Fraud

April 24, 2015 | Aging Services Risk, Quality, & Safety Guidance

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​The owner of a Massachusetts home care agency was sentenced for involvement in a fraudulent Medicare billing scheme, as reported in a February 27, 2015, Federal Bureau of Investigation press release.

The agency owner, a registered nurse, submitted more than $27 million in false and fraudulent home health care claims obtained through a patient recruitment scheme to Medicare from 2006 to 2012. In addition to holding "wellness clinics" at which employees convinced senior citizens to enroll with the agency, the owner and his coconspirator also trained nurses to manipulate patients' Medicare assessment forms to create the appearance of qualifying for home care services. Furthermore, the owner paid a physician to sign home care orders without examining patients; this practice continued after the 2011 introduction of...

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