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Tuesday, September 28, 2010

What's The Difference Between Home Health Care and Foster Care?

Q: What's the difference between home health care fraud and foster care?


A: If you are busted for foster care fraud, you do no prison time and get to keep the money.


Home Health Agency Manager Pleads Guilty in Connection with Detroit Fraud Scheme
WASHINGTON—Detroit-area resident Hassan Akhtar pleaded guilty today to his role in managing a home health care fraud scheme, the Departments of Justice and Health and Human Services (HHS) announced.
Akhtar, 26, pleaded guilty before U.S. District Judge Denise Page Hood of the Eastern District of Michigan to one count of conspiracy to commit health care fraud. At sentencing, scheduled for Jan. 27, 2011, Akhtar faces a maximum penalty of 10 years in prison and a $250,000 fine.

According to plea documents, Akhtar began working for co-conspirator Muhammad Shahab in April 2008. In June 2008, Shahab asked Akhtar if he wanted to assist Shahab in setting up and operating a new home health agency. Akhtar agreed to the arrangement. Shahab helped finance and establish All American Home Care Inc. located in Oak Park, Mich., which also purported to provide home health services. Akhtar was the office administrator and ran the day-to-day operations at All American.

Akhtar admitted that he and his co-conspirators at All American billed Medicare for home health visits that were medically unnecessary and/or never provided. To deceive the Medicare program, Akhtar and his associates created fictitious therapy files that appeared to document physical therapy services provided to Medicare beneficiaries, when in fact no such services had taken place. Akhtar admitted that he knew the fictitious services reflected in the files were billed to Medicare by All American.

Akhtar also admitted that he knew his co-conspirators paid cash kickbacks and other inducements to Medicare beneficiaries, in exchange for the beneficiaries’ Medicare numbers and signatures on documents falsely indicating that they had received home health services from All American. In addition, Akhtar’s co-conspirators secured physician referrals for home health services through the payment of kickbacks to physicians or individuals associated with physicians. Akhtar and his co-conspirators also employed several physical therapists and physical therapy assistants to sign medical documentation necessary to commence Medicare home health billing processes, including initial payments and payments for each visit to a Medicare beneficiary. Akhtar admitted that he knew the physical therapists and physical therapy assistants were not actually conducting a large majority of the visits or treating a large majority of the patients.

Between approximately June 2008 and October 2009, Akhtar and/or his co-conspirators at All American submitted claims to the Medicare program resulting in approximately $4.65 million for physical and occupational therapy services that were never rendered or were medically unnecessary.

Shahab pleaded guilty in February 2010 to one count of conspiracy to commit health care fraud, and is awaiting sentencing.

Today’s guilty plea was announced by Assistant Attorney General Lanny A. Breuer; U.S. Attorney Barbara L. McQuade of the Eastern District of Michigan; Special Agent in Charge Andrew G. Arena of the FBI’s Detroit Field Office; and Special Agent in Charge Lamont Pugh III of the HHS Office of Inspector General’s (HHS-OIG) Chicago Regional Office.

This case was prosecuted by Assistant Chief John K. Neal and Trial Attorney Gejaa T. Gobena of the Criminal Division’s Fraud Section. The case was investigated by the FBI and HHS-OIG. The case was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan.

Since their inception in March 2007, Strike Force operations in seven districts have obtained indictments of more than 810 individuals who collectively have falsely billed the Medicare program for more than $1.85 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to: www.stopmedicarefraud.gov.

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