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Home Health Agency Owner Gets 80 Months for Fraud Conviction

Monday, October 2, 2017   (0 Comments)

By Nushin Huq, Bloomberg BNA

A Louisiana home care agency and its owner were ordered to pay back Medicare $32 million for their roles in a Medicare fraud scheme, prosecutors announced Sept. 21 (United States v. Crinel, E.D. La., No. 2:15-cr-00061, sentenced 9/21/17).

Susie Morgan, U.S. District Judge for the Eastern District of Louisiana, sentenced Lisa Crinel, owner and operator of Abide Home Care Services, to 80 months in prison, followed by three years of supervised release. The company Crinel owned, PCAH Inc., d/b/a Abide Home Care Services Inc., was sentenced to five years of probation. Both Crinel and the company were ordered to pay over $16 million in restitution to Medicare, prosecutors said.

The Health and Human Services Office of Inspector General recognizes home health as vulnerable to fraud and abuse. In 2016, an OIG inspection report found half of all Medicare home health payments in 2015 were improper.

Under the scheme, Crinel hired “house doctors” to set up fraudulent orders and care plans for patients who did not need them, the indictment said. She also instructed her staff not to discharge patients, even those who did not require home health services, prosecutors said.

Abide falsified diagnoses codes and medical records, with the goal of inflating Medicare reimbursement, the government argued. The company and Crinel allegedly also created false employment contracts with doctors and others to cover up illegal kickback relationships.

In 2015, Crinel and Abide were indicted along with 19 other defendants, prosecutors said.

Crinel pleaded guilty to one count of conspiracy to commit health-care fraud and one count of conspiracy to pay and receive illegal kickbacks. The company also pleaded guilty to one count of conspiracy to commit health-care fraud.

Sara Johnson, Crinel's New Orleans-based defense attorney, declined to comment on the case. Assistant U.S. Attorney Patrice Harris Sullivan prosecuted the case for the government.

In May 2017, four doctors and two others were convicted by a jury for their roles in the scheme. Seventeen others already pleaded guilty for their roles, prosecutors said.

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