Detroit Home Health Company Employee Pleads Guilty to Role in Medicare Fraud Scheme
|U.S. Department of Justice April 24, 2013|
WASHINGTON—An employee of Detroit medical service companies that fabricated patient visit notes and other documents as part of a $24 million home health care fraud scheme pleaded guilty today for her role in the conspiracy, announced Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division, U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade, Special Agent in Charge Robert D. Foley, III of the FBI’s Detroit Field Office, and Special Agent in Charge Lamont Pugh, III of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), Chicago Regional Office.
Dana Sharma, 30, of Detroit, pleaded guilty before U.S. District Judge Denise Hood in the Eastern District of Michigan to one count of conspiracy to commit health care fraud.
According to court documents, Sharma worked at purported home health companies, including First Choice Home Health Care Services Inc. and Reliance Home Care LLC, where she and other conspirators agreed to submit false and fraudulent claims to Medicare for home health services. Court documents reveal that, among other things, Sharma organized and maintained company patient files, knowing that these files contained falsified patient visit notes that created the false impression that home health care had been provided to patients. Sharma admitted that she knew that these documents would be used by these companies to submit claims to Medicare for home health services that were not medically necessary and/or not provided.
Court documents allege that between January 2007 and May 2012, Sharma’s conduct caused home health companies to submit claims to Medicare for services that were not medically necessary and/or not provided, which in turn caused Medicare to pay these companies approximately $923,286.
At sentencing, scheduled for August 1, 2013, Sharma faces a maximum penalty of 10 years in prison and a $250,000 fine.
This case is being prosecuted by Trial Attorney William G. Kanellis and Deputy Chief Gejaa Gobena of the Criminal Division’s Fraud Section. It was investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,480 defendants who have collectively billed the Medicare program for more than $4.8 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov.