Home Health & Hospice Week

One state expands its Medicaid Fraud Control Unit to fight scammers. Authorities are throwing the book at fraudulent medical equipment suppliers, and the results are stiff prison sentences. Case No. 1: Enohor Akarue, former owner of Rosewood Medical Supplies in Houston, received a 15-year prison sentence after pleading guilty to theft in relation to a wheelchair billing scheme, according to Texas Attorney General Greg Abbott. In 2002 and 2003, Akarue billed Medicare and Medicaid for devices never provided, Abbott says. He also billed the programs for expensive wheelchairs when he actually provided cheaper scooters. "The suspected overpayments to Akarue by Medicare are $564,000, with another $53,500 coming from Medicaid," Abbott notes in a release. "To save taxpayer dollars and protect Texas seniors, Attorney General Abbott has dramatically expanded [the] MFCU," the release adds. Case No. 2: Angela Isley, former chief operating officer for Orthoscript Inc. in Alpharetta, GA, received a five-year-and-10-month prison sentence after a jury convicted her of health care fraud, mail fraud and money laundering, says U.S. Attorney David Nahmias. Isley also must pay restitution and fines totaling nearly $825,000. Isley was convicted of upcoding wrist braces and walking boots as custom-made items when they were prefabricated, off-the-shelf devices, Nahmias says in a release. Orthoscript overbilled Medicare by $600,000 based on the upcodes, which Isley directed employees to submit despite their protests. Isley was also convicted of embezzlement. She used $360,000 of the company's money to pay off her personal credit cards, the release says. Don't just stand by: Arch Nelson, who was a partner in Orthoscript, drew five years of probation and 250 hours of community service for knowing about but failing to report Isley's crimes. "Today's action sends a message to those who corruptly take advantage of the Medicare system," says OIG Special Agent in Charge Melody Jackson in the release. "The Office of Inspector General ... will continue to work aggressively to eliminate this type of corruption." • It appears home health agencies won't be ignored under Quality Improvement Organiza-tions' upcoming 9th Scope of Work after all. The Centers for Medicare & Medicaid Services earlier indicated that QIOs would dramatically scale back their HHA assistance in the next cycle of their contract (see Eli's HCW, Vol. XVII, No. 14, p. 112). But now CMS says it will launch a new Home Health Quality Campaign under the 9th Scope of Work, according to the National Association for Home Care & Hospice. "The exact nature and extent of new campaign activities under the next SOW was not revealed since QIOs will engage in a competitive bidding process for the home health contract," NAHC says in its newsletter for members. • Providers shouldn't have to face drastic proposals [...]