Info & Intel

Bay Area-based Amity Home Health Care, its CEO Ridhima Singh, Advent Care, and dozens of healthcare industry workers have been charged in connection with a patients-for-cash kickback scheme allegedly created by Singh. Federal prosecutors said in a statement that Amity’s CEO orchestrated a “wine and dine” scheme by which medical professionals received at least $115 million in bribes in exchange for Medicare beneficiary referrals.
According to Singh’s Linkedin...

Many of us have had to seek physical therapy before. Maybe it was after an operation or an accident at work. When we go for our appointment, we automatically assume the therapist is properly licensed and qualified. A recent case from Alabama suggests that isn’t always the case.
A former physiologist who worked at the Baldwin Bone & Joint clinic in Baldwin, Alabama blew the whistle on his former employer. He said the clinic was using physiologists, athletic trainers, assistants,...

A new elaborate Medicare scam is targeting seniors nationwide. One of its most recent victims was an 86-year-old woman from Utah, who spoke to reporters on condition of anonymity.
The woman, who lives in a rural area, was persuaded by two young people who knocked on her door to hand over her Medicare number, her SSN, and even a sample of her DNA. The object of the fraudsters was to bill Medicare for DNA tests covered by the government program.
Older Medicare beneficiaries all...

A former healthcare provider received a seven-month prison term and was ordered to pay $1.3 million in restitution for Medicaid fraud. Nikkita Chesney, 46, Bridgeport, also requires three years of supervised release once she has served her time in prison.
Medicaid Identity Theft In 2012, Chesney was working at a Bridgeport facility offering substance abuse treatment and a detoxification program. Toshirea Jackson, who owned the psychotherapy and social services businesses Transitional...

When it comes to Medicaid fraud, sometimes it’s all in the family. On July 11, Qaiser Gondal, 47, pleaded guilty in U.S. District Court to conspiring to defraud Medicaid. The Watervliet, New York man was the owner of Ti Taxi, Inc., a Ticonderoga-based medical transportation company. He faces up to 10 years in prison and a $250,000 fine, and has agreed to pay $325,000 in restitution. Sentencing is scheduled for November 14.
A day earlier, his brother, Khurram Gondal, 38,...

Seven people living in the same Bridgeport, Alabama apartment complex are now charged with Medicaid fraud in neighboring Tennessee. The state line is just six miles from Bridgeport. Their whole scheme unraveled because of an anonymous tip.
All seven claimed they were Tennessee residents so they could receive TennCare, the state’s Medicaid program. In Tennessee, Medicaid fraud is a class D felony, punishable by prison sentences running from two to 12 years.
If the Medicaid...

Hart to Heart, an ambulance service provider operating in Salisbury, has agreed to pay $1.25 million to resolve allegations for submitting false claims for payment to Medicare between 2010 and 2017.
In 2015, a whistleblower filed a False Claims Act lawsuit alleging that Hart to Heart was billing Medicare for ambulance transports that were medically unnecessary. Though it agreed to a sizable settlement, the Maryland-headquartered company has made no admission of guilt.
"Hart to Heart...

A Monroe, North Carolina man pleaded guilty to Medicaid fraud on June 20, and now faces up to 15 years in prison. Jerry Taylor pleaded guilty to healthcare fraud and tax evasion. He admitted conspiring with healthcare providers over a two-year period and submitting Medicaid claims for children who were not treated by these providers.
Taylor conspired with Devon Rambert-Hairston, a Monroe nurse practitioner, who pleaded guilty in April to money laundering, as well as collecting...

Did you know that Medicare publishes ratings of nursing homes? They are free and available online. You can see a numerical rating of the facility as well as key data on recent inspections, staffing and health and safety issues. Some states also publish inspections data.
Medicare publishes these nursing home ratings in the hopes that families will do comparison shopping before selecting a long term care facility.
In this post we will highlight one particular facility - the Grace...