Owners of Woodbridge Home Health Business Sentenced to 121 Months for Health Care Fraud and Aggravated Identity Theft

ALEXANDRIA, VA—The owners of a Woodbridge, Virginia-based home health care business were sentenced today to 121 months in prison, followed by three years of supervised release, for submitting more than $2.1 million in false claims to Virginia Medicaid and Antehm Blue Cross and Blue Shield (BCBS) for reimbursement of services they did not provide.

Neil H. MacBride, United States Attorney for the Eastern District of Virginia; Ken Cuccinelli, Attorney General of Virginia; and Valerie Parlave, Assistant Director in Charge of the FBI’s Washington Field Office, made the announcement after sentencing by United States District Judge Claude M. Hilton.

Irvine Johnston King, 46, and Aisha Rashidatu King, 40, of Woodbridge, were convicted at trial on January 10, 2013, of conspiracy and multiple counts of health care fraud, in addition to two counts of aggravated identity theft. At sentencing today, they were also ordered by the court to pay $931,894 in restitution and to forfeit the same amount.

According to court records and evidence at trial, the Kings owned and operated Bright Beginnings Healthcare Services, a business that provided in-home personal and respite care and private duty nursing services to Medicaid-eligible individuals. From at least January 2008 through June 2011, the Kings carried out a scheme to defraud the Virginia Medicaid program and Anthem Blue Cross and Blue Shield (BCBS) by submitting inflated claims for services. They submitted $2.1 million in fraudulent claims, of which Virginia Medicaid paid out $766,620 and BCBS paid out $165,273.

In May 2009, after learning that Virginia Medicaid had retained an outside firm to audit Bright Beginnings, the Kings began an extensive effort to cover up the fraud by creating false nursing documentation to support the claims, including timesheets and notes in the names of several nurses who had never worked at Bright Beginnings. They supervised an unlicensed employee who completed timesheets under the name of a licensed nurse and billed the employee’s time to Virginia Medicaid as licensed practical nursing services. They also directed the father of a patient to sign blank timesheets, which were then falsified to support fraudulent billing for services that had never been provided to that patient.

The investigation was conducted by FBI’s Washington Field Office and the Virginia Attorney General’s Medicaid Fraud Control Unit, with the assistance of the Virginia Department of Medical Assistance Services. Assistant U.S. Attorney Timothy D. Belevetz and Special Assistant U.S. Attorney Steven W. Grist of the Virginia Attorney General’s Office are prosecuting the case on behalf of the United States.

A copy of this press release may be found on the website of the United States Attorney’s Office for the Eastern District of Virginia at http://www.justice.gov/usao/vae.