Medicaid Fraud in My Back Yard
November 7, 2013
Home Health Fraud in Woodbridge, VA $2.1 Million!
United States Attorney’s Office Eastern District of Virginia United States Attorney Neil H. MacBride
Joint release from Attorney General Ken Cuccinelli and U.S. Attorney Neil MacBride…
Owners of Woodbridge home health care business sentenced to 121 months for $2.1 million in health care fraud
– Billed for in-home personal care and nursing services they did not provide to patients –
ALEXANDRIA, VA (March 22, 2013) – The owners of a Woodbridge-based home health care business were sentenced today to 121 months in prison each, followed by three years of supervised release, for submitting more than $2.1 million in false claims to Virginia Medicaid and Anthem Blue Cross and Blue Shield (BCBS) for reimbursement of in-home personal care and nursing services they did not provide.
Attorney General Ken Cuccinelli; Neil H. MacBride, U.S. attorney for the Eastern District of Virginia; and Valerie Parlave, assistant director in charge of the FBI’s Washington Field Office, made the announcement after sentencing by U.S. District Judge Claude M. Hilton.
Irvine Johnston King, 46, and Aisha Rashidatu King, 40, of Woodbridge, the owners and operators of Bright Beginnings Healthcare Services, were convicted at trial on Jan. 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.
The business was to provide in-home personal and respite care and private duty nursing services to Medicaid-eligible individuals. According to court records and evidence at trial, 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 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. Special Assistant U.S. Attorney Steven W. Grist of the Virginia attorney general’s office and Assistant U.S. Attorney Timothy D. Belevetz and are prosecuting the case on behalf of the United States.
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