Local In-Home Health Care Provider Pleads Guilty to Fraud Charges
|U.S. Attorney’s Office May 01, 2014|
ST. LOUIS, MO—TINA KUEHL pled guilty yesterday to bank fraud charges involving her fraudulent statements involving payment of a bank loan. In a separate, unrelated case, she and her company, Better Way Home Care, pled guilty to multiple health care fraud charges. Kuehl and Better Way represented on billing work sheets and claim forms that patients had received therapy services when they knew that the patients had not received the therapy. Kuehl and Better Way caused the submission of hundreds of reimbursement claims to Medicare for services which they knew had not been provided.
According to court documents regarding the bank fraud charges, in December 2010 Kuehl’s mother obtained a $305,000 property loan from the Community Bank of Owensville, Missouri, a branch of the Maries County Bank. Both Kuehl and her mother are listed on the deed of trust for the property. On many occasions, they did not make timely payments on the loan and in July 2013, Maries Bank foreclosed on the property. After the foreclosure, Kuehl devised a scheme to defraud Maries Bank by submitting fraudulent checks as proof that she had made loan payments to the bank. On six occasions, she changed the payee on copies of unrelated cancelled checks so that it would appear that she had made loan payments to Community Bank of Owensville. She continued the fraud by claiming to have made cash payments to a bank employee on two occasions. The bank employee was on sick leave on the day Kuehl claimed she made the first $4,000 cash payment to the employee at the bank. Kuehl claimed that she made a second cash payment of $6,900 to a bank employee at a truck stop. Finally, Kuehl retained attorneys to represent her after the foreclosure, and falsely told them she had made payments by checks and cash, which the bank had not credited to her loan account.
According to court documents regarding the healthcare fraud charges, Better Way was a home health care agency located in Ellisville, Missouri. Tina Kuehl was the owner, president and administrator of Better Way and was responsible for the day-to-day operations. Medicare pays home health agencies for 60-day episodes of care. Medicare makes two payments to the home health care agencies, the first before the service is provided based on the patient’s anticipated need for services and a second payment at the end of the 60-day episode of care based on the actual number of services provided.
Kuehl has no medical or health care education, training, or experience, which would qualify her to assess or evaluate patients or determine their care needs. Prior to opening Better Way, she worked in the cosmetology field. Better Way hired nurses and contracted with therapists to assess and evaluate patients and to determine the patients’ needs for therapy services. Better Way staff recorded this information on the Outcome and Assessment Information Set form (OASIS).
To increase the reimbursement that Better Way would receive, Kuehl directed Better Way nurses and other employees to make false statements on the OASIS forms and the reimbursement claim forms. At Kuehl’s direction, the staff increased the number of therapy visits, although Kuehl knew the patients did not need and had not received the therapy; falsified the diagnosis codes; and exaggerated the patients’ conditions and the reasons the patients were receiving home health care services from Better Way. When some employees refused to increase the number of therapy visits, Kuehl personally increased the number of visits. In some instances the patient had received no therapy at all.
Kuehl, of Ballwin, Missouri, pled guilty to one felony count of bank fraud, one felony count of health care fraud, two counts of making false statements relating to health care, and one count of making false statements to federal agents. She appeared before United States District Judge Henry Autrey on Wednesday, April 30. Sentencing has been set for July 28, 2014.
Bank fraud carries a maximum penalty of 30 years in prison and/or fines up to $1 million; health care fraud carries a maximum penalty of 10 years prison and/or fines up to $250,000; and each of the other charges carry a maximum of five years in prison and/or fines up to $250,000. In determining the actual sentences, a judge is required to consider the U.S. Sentencing Guidelines, which provide recommended sentencing ranges.
This case was investigated by the Office of the Inspector General of the U.S. Department of Health and Human Services, the FBI, and the Missouri Fraud Control Unit of the Missouri Attorney General’s Office. Assistant United States Attorney Dorothy McMurtry is handling the case for the U.S. Attorney’s Office.