Authors

  1. Locher, David JD
  2. Clark, Kyle JD
  3. George, Andrew JD

Article Content

Recent indictments and sentences highlight the mix of government agencies involved in efforts to root out and deter home healthcare fraud. On November 27, 2018, the U.S. Attorney's Office for the Western District of Pennsylvania announced it had charged 12 individuals in a 22-count indictment. The government alleges that sisters Arlinda Moriarty and Danyelle Dickens operated multiple home healthcare companies through which they, aided by other defendants, fraudulently billed Pennsylvania Medicaid for millions of dollars for services never provided-often by fictitious employees, or for consumers who were hospitalized or who had passed away. The investigation involved not only the FBI, but also five other state and federal agencies: the Pennsylvania Office of the Attorney General, Internal Revenue Service-Criminal Investigation, U.S. Department of Health and Human Services-Office of Inspector General, and United States Postal Inspection Service.

 

Interagency cooperation in healthcare fraud investigations has become the new normal. The government launched a multiagency Health Care Fraud Strike Force in Miami in 2007. Now, Strike Force teams also operate in Los Angeles, Detroit, Houston, Brooklyn, Tampa, Chicago, Dallas, Newark, Philadelphia, and Southern Louisiana, as well as an Appalachian Regional Strike Force, which was just formed in October.

 

These strike force teams remain active, particularly in investigating home healthcare fraud. Recently, the Dallas Strike Force investigated a home healthcare agency that billed Medicare and Medicaid for $3.7 million that the agency was ineligible to receive because its two owners had been excluded from participating in federal healthcare benefit programs. The owners and two other employees were convicted in October and await sentencing.

 

Also in October, a patient recruiter in the Houston area was sentenced to 9 years in prison for her role in a $3.6 million home healthcare fraud in which she accepted kickbacks and submitted claims for home healthcare services that were not medically necessary or that were not actually provided. Her case was investigated by the Houston Strike Force.

 

Another recent example is the Detroit Strike Force's arrest and conviction of Muhammed Qazi, who operated a home care agency that fraudulently billed Medicare millions of dollars for home medical services that were either unnecessary or not actually provided. In August of 2018, Qazi was sentenced to 42 months in prison and ordered to provide over $6.5 million in restitution.

 

The Detroit Strike Force appears to be particularly focused on home healthcare fraud. The Department of Justice website for Detroit Strike Force Operations states that the Detroit Strike Force has "been traditionally successful in prosecuting fraud in home health," and asserts that "[t]hese efforts have helped to create a reduction in Medicare payments to home health groups" (US Department of Justice, 2015). See Figure 1 highlighting the decline.

  
Figure 1 - Click to enlarge in new windowFigure 1. Medicare Payments for Home Health, Calendar Year 2006-2013 Q1

Since the Strike Force's inception, Strike Force teams have charged nearly 4,000 defendants who have billed Medicare over $14 billion.

 

Interestingly, the recent indictment of Moriarty and others was not publicly described as a Strike Force operation. Nevertheless, in that case, six different state and federal agencies worked together to investigate the matter-showing the broad range of state and federal law enforcement agencies that are continuing to collaborate closely to fight home healthcare fraud.

 

More Adults and Children Are Using Yoga and Meditation

NIH: Over the past five years, more Americans of all ages are rolling out their yoga mats and meditating. A large nationally representative survey shows that the number of American adults and children using yoga and meditation has significantly increased over previous years and that use of chiropractic care has increased modestly for adults and held steady for children.

  
Figure. No caption a... - Click to enlarge in new windowFigure. No caption available.

Survey highlights for adults:

 

* Yoga was the most commonly used complementary health approach among U.S. adults in 2012 (9.5 percent) and 2017 (14.3 percent). The use of meditation increased more than threefold from 4.1 percent in 2012 to 14.2 percent in 2017.

 

* The use of chiropractors increased from 9.1 percent in 2012 to 10.3 percent in 2017.

 

* In 2017, women were more likely to use yoga, meditation, and chiropractors in the past 12 months than men.

 

* Non-Hispanic white adults were more likely to use yoga, meditation, and chiropractors than Hispanic and non-Hispanic black adults.

 

 

Survey highlights for children:

 

* The percentage of children aged 4-17 years who used yoga in the past 12 months increased significantly from 3.1 percent in 2012 to 8.4 percent in 2017.

 

* Meditation increased significantly from 0.6 percent in 2012 to 5.4 percent in 2017.

 

* There was no statistically significant difference in the use of a chiropractor between 2012 and 2017 (3.5 percent and 3.4 percent, respectively).

 

* In 2017, girls were more likely to have used yoga during the past 12 months than boys.

 

* In 2017, older children (aged 12-17 years) were more likely to have used meditation and a chiropractor in the past 12 months than younger children (aged 4-11 years).

 

* Non-Hispanic white children were more likely to have used yoga and a chiropractor in the past 12 months than non-Hispanic black children or Hispanic children.

 

 

REFERENCE

 

US Department of Justice. (2015). Detroit Strike Force Operations. Retrieved from https://www.justice.gov/criminal-fraud/detroit-strike-force-operations[Context Link]