For many elderly people in Texas who suffer from ongoing health problems, in-home health care can be an invaluable service. However, state authorities believe that one home health agency might have been submitting invalid claims for reimbursement. As such, a dozen individuals have been indicted on allegations of health care fraud.
Although the fraud allegedly began as far back as Aug. 2013, the 12 people involved in the investigation were not indicted until recently. According to investigators, the alleged operation lasted from Aug. 2013 until Nov. 2014, during which time employees with Three Angels Home Health supposedly sought out individuals who did not qualify for in-home care. Authorities claim that the agency then paid these people anywhere from $100 to about $200 in order to encourage them to sign up for Medicare insurance.
It is believed that the agency was so eager to sign on new patients for in-home health care because it was then reimbursed $500 for every beneficiary. The operation is believed to have defrauded the Medicare program of roughly $2.5 million. That figure apparently stems from the approximate 250 Texas patients who were receiving health care in their homes who might not have actually qualified for the services.
A total of 18 separate indictments involving health care fraud were handed down by the grand jury. However, these indictments should in no way be confused for any type of criminal conviction. An indictment simply indicates that a jury has found sufficient reason for a criminal case to move forward, and as such, all 12 defendants are still considered innocent. Even after an indictment, it is still up to the prosecution to bear the full burden of proof.
Source: cbs19.tv, “East Texas Federal Grand Jury Indicts 12 in Medicare Fraud Scheme”, Sept. 23, 2015