Former Home Healthcare Nurse Sentenced for Medicaid Fraud in Case that Resulted in Minor’s Death

Wednesday, July 26, 2017

DAYTON, Ohio – Mollie Parsons, 47, of Middletown, Ohio, was sentenced in U.S. District Court to 36 months in prison for healthcare fraud related to the death of a severely physically disabled minor.

She was previously sentenced by the state to serve 10 years in prison for her role in the death of her minor patient, and her federal sentence will be served consecutive to her state one. She is also banned from working for any governmental entity in the healthcare field for life.

Benjamin C. Glassman, United States Attorney for the Southern District of Ohio, and Lamont Pugh, Special Agent in Charge, Health and Human Services Office of Inspector General (HHS-OIG), announced the sentence handed down today by U.S. District Judge Walter H. Rice.

According to the Statement of Facts in this case, Parsons was employed as a home healthcare nurse for a minor with severe physical impairments from at least 2009 until March 2011. Parsons was paid through Medicaid to provide daily nursing services, including but not limited to, wound care, personal hygiene maintenance and feeding assistance. The child under her care was unable to communicate, completely paralyzed and dependent upon feeding tubes.

Rather than working her eight-hour shift and providing the nursing services, Parsons was frequently absent from the home for extended periods of time. To conceal her neglect, the defendant submitted false claims to Medicaid to receive fraudulent payments for private duty nurse services.

Parsons pleaded guilty in the federal case in January 2016 to two counts of healthcare fraud.

“Parsons’ actions directly undermined the purpose for which Medicaid compensated her – providing medical care to a severely disabled child – as she deprived a child with cerebral palsy of the most basic medical care and comfort,” U.S. Attorney Glassman said. “The state prosecution served as the primary mechanism to address and punish the child victim’s death, but could not address the fraud against Medicaid. This federal prosecution therefore provides accountability for her fraudulent conduct as it relates to Medicaid.”

U.S. Attorney Glassman commended the cooperative investigation by HHS-OIG, as well as Assistant United States Attorney Brent G. Tabacchi and Deputy Criminal Chief Laura I. Clemmens, who are representing the United States in this case.

Three Companies and Their Executives Pay $19.5 Million to Resolve False Claims Act Allegations Pertaining to Rehabilitation Therapy and Hospice Services

Monday, July 17, 2017

Ohio based Foundations Health Solutions Inc. (FHS), Olympia Therapy Inc. (Olympia), and Tridia Hospice Care Inc. (Tridia), and their executives, Brian Colleran (Colleran) and Daniel Parker (Parker), have agreed to pay approximately $19.5 million to resolve allegations pertaining to the submission of false claims for medically unnecessary rehabilitation therapy and hospice services to Medicare, the Department of Justice announced today.

“Clinical decisions should be based on patient needs rather than corporate profits,” said Acting Assistant Attorney General Chad A. Readler of the Justice Department’s Civil Division. “This settlement reflects the Department’s continuing commitment to safeguarding patients and the Medicare system.”

FHS is the corporate successor to Provider Services Inc. (PSI), which provided management services to skilled nursing facilities. In 2010, PSI was merged into BCFL Holdings Inc. (BCFL), which was renamed FHS in 2013. Olympia provided rehabilitation therapy services to patients at the skilled nursing facilities managed by PSI and BCFL. Tridia Hospice Care Inc. provided hospice care services. Colleran and Parker partially controlled or owned PSI, BCFL, FHS, Olympia, and Tridia between 2008 and 2013.

The settlement resolves allegations that, from January 2008 through December 2012, Olympia and PSI/BCFL submitted, or caused the submission of, false claims to Medicare for medically unnecessary rehabilitation therapy services at 18 skilled nursing facilities. The government contended that the therapy services were provided at excessive levels to increase Medicare reimbursement for those services.

The settlement further resolves allegations that, from April 2011 through December 2013, Tridia submitted false claims to Medicare for hospice services provided to patients who were ineligible for the Medicare hospice benefit because Tridia failed to conduct proper certifications or medical examinations. The settlement also resolves allegations that from January 2008 through December 2012, Colleran and Parker solicited and received kickbacks to refer patients from skilled nursing facilities managed by PSI or BCFL to Amber Home Care LLC, a home health care services provider.

“This is one of the largest nursing home operations in Ohio,” said U.S. Attorney Benjamin C. Glassman for the Southern District of Ohio. “It is unacceptable for an entity entrusted to care for our most vulnerable and elderly citizens to make decisions based on profit, not quality of care. Subjecting the elderly to inappropriate levels of therapy can be physically harmful, and failing to properly certify and re-certify hospice patients can have a devastating impact on the patients and their families.”

As part of the settlement, FHS and Colleran have entered into a five-year Corporate Integrity Agreement (CIA) with the HHS Office of Inspector General (HHS-OIG). The CIA is designed to increase the accountability and transparency of FHS and Colleran so that they will avoid or promptly detect future fraud and abuse.

“Medicare providers have a legal and moral obligation to provide only those services that are medically necessary and to ensure that claims seeking payment accurately reflect the services that are actually provided,” said Special Agent in Charge Lamont Pugh III of the U.S. Department of Health & Human Services, Office of Inspector General (HHS-OIG). “The misrepresentation or falsification of those claims not only violates provisions of the False Claims Act but the public’s trust. The OIG will continue to aggressively investigate allegations of potential violations of this nature.”

The settlement resolves allegations filed in two separate lawsuits by Vladimir Trakhter, a former Olympia employee, and Paula Bourne and La’Tasha Goodwin, former Tridia employees, in federal court in Columbus, Ohio. The lawsuits were filed under the qui tam, or whistleblower, provisions of the False Claims Act, which permit private individuals to sue on behalf of the government for false claims and to share in any recovery. Mr. Trahkter will receive approximately $2.9 million and Ms. Bourne and Ms. Goodwin collectively will receive $740,000.

The settlement is the result of a coordinated effort by the Civil Division’s Commercial Litigation Branch and the U.S. Attorney’s Office for the Southern District of Ohio, with assistance from HHS-OIG, the HHS Office of Counsel to the Inspector General, and the Ohio Medicaid Fraud Control Unit.

These cases are captioned United States ex rel. Trakhter v. Provider Services, Inc., n/k/a BCFL Holdings, Inc., et. al., Case No. 1:11-CV-217, and United States ex rel. Bourne and Goodwin v. Brian Colleran, et. al., Case No. 1:12-CV-935. The claims resolved by the settlement are allegations only, and there has been no determination of liability.

Indiana Livestock Broker Charged with Fraud, Money Laundering

Thursday, July 13, 2017

CINCINNATI– A federal grand jury has charged Brian D. Jones, 38, of Vevay, Indiana with defrauding investors in his livestock brokerage business.

Benjamin C. Glassman, United States Attorney for the Southern District of Ohio and Angela L. Byers, Special Agent in Charge, Federal Bureau of Investigation (FBI), Cincinnati Field Office, announced the indictment which was unsealed today.

The indictment alleges that Jones operated a business buying bull calves from dairy farms in Wisconsin and selling them to cattle ranches in Texas and Missouri. He began soliciting investors in 2015, promising sizable returns for the investments.

Rather than invest the funds, the indictment alleges, Jones used the funds for his personal benefit such as gambling at casinos. The indictment also alleges that Jones used the investment funds to pay “returns” back to earlier investors as if the funds had actually generated income through investment in his business. By the end of 2015, the indictment says, Jones had squandered funds from the cattle purchasers and was in debt with his suppliers and purchasers. Investigators are still calculating the number of investors and the amount of money involved in the alleged fraud.

“The indictment alleges that Jones fabricated bank documents to show that he had sizable business deposits that would soon be ‘released’ by the bank,” U.S. Attorney Glassman said. “He also allegedly sent checks to investors including some in the Southern District of Ohio for investment returns, only to have the checks bounce due to insufficient funds in his account.”

Jones faces four counts of wire fraud, each punishable by up to 20 years in prison and a $250,000 fine if he’s convicted. The indictment also charges him with four counts of money laundering. Three are punishable by up to ten years in prison. One money laundering charges carries a potential sentence of 20 years in prison. Two additional counts seek forfeiture of all property and proceeds of any crimes of which Jones is convicted.

FBI agents arrested Jones in southern Indiana today. Jones appeared U.S. Magistrate Judge Stephanie Bowman for an initial appearance and to schedule further court dates.

U.S. Attorney Glassman commended the investigation of this case by the FBI, as well as Assistant United States Attorney Timothy S. Mangan, who is prosecuting the case.

An indictment merely contains allegations, and the defendant is presumed innocent unless proven guilty in a court of law.