Home Health Agencies Charged in Medicare Fraud

A Dallas-area doctor and the owners of five home health care agencies were charged on Tuesday with $375 million in fraud against Medicare and Medicaid, the largest such fraud case yet, prosecutors said.The alleged frauds included medically unnecessary home health visits under a program meant to help aging and disabled people stay in their own homes."The conduct charged in this indictment represents the single largest fraud amount orchestrated by one doctor in the history of the Health Care Fraud Prevention & Enforcement Action Team (HEAT) and our Medicare Fraud Strike Force operations," Deputy U.S. Attorney General James Cole said in a statement.Dr. Jacques Roy, owner of Medistat Group Associates in Rockwall, Texas; Cynthia Stiger, of Dallas; Wilbert James Veasey Jr., of Dallas; Cyprian Akamnonu, of Cedar Hill, Texas; Patricia Akamnonu, of Cedar Hill; Teri Sivils, of Midlothian, Texas; and Charity Eleda, of Rowlett, Texas are all charged with health care fraud and other charges."Between January 2006 and November 2011, Medistat certified more Medicare beneficiaries for home health services and had more purported patients than any other medical practice in the United States," the Justiceand Health and Human Services departments said in a joint statement."These certifications allegedly resulted in more than $350 million being fraudulently billed to Medicare and more than $24 million being fraudulently billed to Medicaid by Medistat and Home Health Agencies."HHS Inspector General Daniel Levinson said agents looked at billing spikes to target Roy and his colleagues. "In this case, our analysts discovered that in 2010, while 99 percent of physicians who certified patients for home health signed off on 104 or fewer people, Dr. Roy certified more than 5,000," Levinson said.HHS has stepped up fraud prosecution efforts. It saidMedicare Fraud Strike Force operations have charged more than 1,190 people in cases worth $3.6 billion since they were begun in 2007.