Thursday, January 26, 2017

Psychologists convicted in 25 million dollar health care fraud

Two owners of psychological services companies, one of whom was a clinical psychologist, were convicted yesterday for their involvement in a $25.2 million Medicare fraud scheme carried out through eight companies at nursing homes in four states in the Southeastern United States.
Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division, U.S. Attorney Kenneth A. Polite of the Eastern District of Louisiana, Special Agent in Charge Jeffrey S. Sallet of the FBI’s New Orleans Field Office and Special Agent in Charge C.J. Porter of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Dallas Regional Office made the announcement.
Rodney Hesson, Psy.D, 47, of Slidell, Louisiana, licensed clinical psychologist and owner of Nursing Home Psychological Service of Louisiana LLC, Nursing Home Psychological Service of Mississippi LLC, Nursing Home Psychological Services of Florida LLC and Nursing Home Psychological Service of Alabama LLC (collectively NHPS), and Gertrude Parker, 63, of Slidell, Louisiana, owner of Psychological Care Services of Louisiana, Psychological Care Services of Mississippi, Psychological Care Services of Alabama and Psychological Care Services of Florida (collectively PCS), were convicted following a seven-day jury trial in the Eastern District of Louisiana.  They were each convicted of one count of conspiracy to commit health care fraud and one count of conspiracy to make false statements related to health care matters.  The jury verdict included a money judgment of $8,956,278, as well as forfeiture of Hesson’s home and at least $525,629 in seized currency.  A sentencing hearing for both defendants is set for May 4, 2017, before U.S. District Court Judge Carl J. Barbier of the Eastern District of Louisiana.  
According to evidence presented at trial, the defendants’ companies contracted with nursing homes in Alabama, Florida, Louisiana and Mississippi to allow NHPS and PCS clinical psychologists to provide psychological services to nursing home residents.  Hesson and Parker caused these companies to bill Medicare for hours of psychological testing services that these nursing home residents did not need or in some instances did not receive.  Between 2009 and 2015, NHPS and PCS submitted over $25.2 million in claims to Medicare, a significant amount of these claims being fraudulent.  Medicare paid more than $13.5 million on the fraudulent claims.
The FBI and HHS-OIG investigated the case, which was brought by the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Louisiana.  Senior Litigation Counsel John Michelich and Trial Attorneys Katherine Raut and Katherine Payerle of the Fraud Section are prosecuting the case.
The Fraud Section leads the Medicare Fraud Strike Force. Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged over 3,000 defendants who collectively have billed the Medicare program for over $11 billion. In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
Since they took it to trial and lost, they can expect to be hammered at sentencing. My heart goes out to them for they will suffer in federal prison. To see what they can expect, go here.... https://www.amazon.com/PRISON-expect-Federal-Bureau-Prisons-ebook/dp/B011GTWLOG
PRISON: what to expect in Federal Bureau of Prisons (Prison series Book 1) by [Langner, David, David, Earl]

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