The Justice Department has recovered more than $2.75 billion in false claims against healthcare providers and charged 193 defendants so far this year in criminal cases through its 2024 National Health Care Fraud Enforcement Action, and many of the cases involve nursing homes, home health or hospice agencies, and assisted living providers, according to a Thursday report from the department’s criminal division.
“The Justice Department has been clear that we will bring to justice criminals who defraud Americans and steal from taxpayer-funded programs. We take a particularly aggressive approach to combating health care fraud schemes that put people in danger for the sake of profits,” Attorney General Merrick B. Garland said in a statement.
Among the cases cited:
- Eva LeBeau, owner of Prestigious Senior Home Health Care in Clearwater, FL, and Lori Lebrecht, director of nursing, are accused of submitting more than $2 million in false and fraudulent Medicare claims for home health services and of paying kickbacks to recruiters to refer patients to Prestigious. “Medicare paid approximately $1.3 million based on the false and fraudulent claims,” the Justice Department said.
- In Michigan, Ibrahim Sammour and Bashier Sammour, operators of Individualized Home Health Care, were charged in connection with an alleged scheme to fraudulently obtain more than $2 million from Medicare by submitting false and fraudulent claims for home healthcare services that were medically unnecessary, not provided as represented or not rendered. Five others were also charged by information — two registered nurses, two group home owners and a licensed practical nurse — for their alleged involvement.
- Also in Michigan, Ruby Scott, owner of Delta Home Health Care, was charged for an alleged scheme to fraudulently obtain more than $2.2 million in Medicare funds by submitting claims for home healthcare services obtained through the payment of illegal kickbacks to patient recruiters, in violation of the Anti-Kickback Statute.
- In Texas, Ijeoma Victoria Ehieze, owner of Sanctified Home Health Services, was charged in connection with an alleged scheme to fraudulently obtain more than $1.5 million in Medicare and Medicaid funds. Ehieze allegedly billed Medicare and Medicaid for home health services that were not provided and/or medically unnecessary and based on illegal kickback payments to marketers and patients, and was paid more than $1 million on those false and fraudulent claims.
- In California, Giacomo Lorenzo Garbarino was charged in an alleged scheme to defraud the In-Home Supportive Services and Medi-Cal programs by submitting claims for healthcare services that either were never performed or did not qualify for reimbursement under program rules. According to the Justice Department, Garbarino “fraudulently billed the programs a total of $172,568.52 for in-home supportive services provided on days when the recipient of the services was hospitalized or living in a skilled nursing facility. Under the rules of the IHSS program, such services qualify for reimbursement under the Medi-Cal program only if the recipient is living in his own home when the services are provided.”
- In Tennessee, Christopher Caleb Mullins and Barbara Megan Mullins, along with their company, CAMM Care LLC, doing business as Patriot Homecare, were charged after they allegedly “conspired with each other and others not named in the indictment to create and submit fraudulent payment claims for homecare services that were not actually rendered.”
- Kristin S. Sturdivant, RN, is accused of falsifying records in Indiana. “While working at a nursing home, [Sturdivant] signed out narcotics for patient use but did not administer the medication to the patients on numerous occasions,” the Justice Department said.
- Amy Nicole Mullins allegedly stole medication prescribed to a resident of the skilled nursing facility in Evansville, IN, when she was working.
- Autumn Marie Duvall, RN, is alleged to have stolen narcotic pain medication prescribed for two residents of an assisted living community in Evansville, IN.
- Myah Alise Samples, a qualified medication aide, was charged after allegedly taking narcotic pain medication prescribed to an assisted living resident in Evansville, IN.
- Rebecca E. Plaza, LPN, is accused of diverting hydromorphone from the inventory in the Indiana nursing home where she worked.
- Others are charged in various parts of the country with allegedly stealing credit cards and goods for nursing home residents under their care, as well as criminal recklessness.
Garland said the Justice Department focuses on four principles in combating healthcare fraud: protecting vulnerable patients, defending taxpayer-funded programs, ensuring full accountability by prosecuting the perpetrators of the crimes and seizing their criminal proceeds, and using data analytics to keep pace with constantly evolving fraud schemes.
