August 28, 2018

Once Again, Home Health Care Fraud….

Editor’s note: Here’s an interesting blog post from our archives that we thought was worth sharing again. The False Claims Act has enabled whistleblowers to expose fraudulent healthcare fiscal violations, while getting financial rewards for their efforts. We feel this is justice being served indeed.

“The Department of Justice announced another guilty plea for one count of conspiracy to commit health care fraud related to the home health care industry.  This time Beverly Cooper, a registered nurse, pleaded guilty for her role in fabricating nursing visit forms connected to a $24 million home health care fraud conspiracy.

Ms. Cooper worked with home health care companies in the Detroit, Michigan area, including Reliance Home Care LLC, First Choice Home Health Care Services Inc. and Accessible Home Care Inc.  She routinely fabricated nursing visits notes and other documents to give the impression to Medicare that home health care services were provided.  These fabricated documents were the basis of and supported the fraudulent claims submitted to Medicare for reimbursement.  In fact, these home health care services were not medically necessary and/or not provided.  Ms. Cooper also signed the nursing visit forms for home visits made by other unlicensed individuals, giving the false impression that she actually provided the services.  Ms. Cooper understood that the fraudulent documents she created would be used to support the claims the home health care companies submitted to Medicare for services that were not medically necessary and/or not provided.

In addition to fabricating the nursing visit forms, Ms. Cooper and her co-conspirators participated in staged home health care visits during inspections from Medicare.  The co-conspirators posed as employees of the home health care services companies and treated fake patients to give the inspectors the impression that the companies were legitimate and the home health care services for which they billed Medicare were actually being provided.

Between 2006 and May 2012, Ms. Cooper’s conduct caused fraudulent claims to be submitted to Medicare. The companies received approximately $5,403,703 from Medicare for Ms. Cooper’s participation in the scheme.

Cooper faces a maximum of ten years in prison and $250,000 fine at her sentencing scheduled for July 23, 2013.”

Berg & Androphy has a practice area devoted to False Claims Act violations, Qui Tam and whistlelower representation. Please visit our Qui Tam FAQ page to learn more and gain a better understanding on this complicated area of our legal system.