A Miami-area assisted living facility owner has been sentenced to 37 months in prison for her role in a more than $1.1 million Medicare fraud scheme, says the Department of Justice. Billy Denica was sentenced by U.S. District Judge Joan Lenard in Miami, Fla.; in addition to her prison term, she was sentenced to two years of supervised release and has been ordered to pay $538,875 in restitution.
The kickback scheme involved funneling patients to a fraudulent mental health provider, American Therapeutic Corporation, in exchange for illegal healthcare kickbacks. Denica, the owner of Robyll Care Assisted Living Facility, admitted she knew ATC falsely billed Medicare for partial hospitalization programs (PHP)—a form of intensive treatment for severe mental illness—based on her fraudulent referrals, court documents say.
Some of her Robyll residents would be offered gifts such as money, cigarettes, and candy in exchange for agreeing to be admitted to the hospital, so they could then be referred to ATC. Denica herself would also refer her residents to the fraudulent corporation in order to receive cash kickbacks for those who went.
The ALF owner’s participation in the fraud resulted in more than $1.1 million in fraudulent billing to the Medicare system, according to the plea agreement.
Full Article and Source:
Fla. Assisted Living Facility Owner Sent to Prison for $1.1 Million Medicare Fraud Scheme
8 comments:
A great initiative from you guys! We love the sharing of knowledge!
When the Department of Justice gets involved, it does good work. But, why won't they take on the issue of guardianship abuse?
It's up to government to protect its people - the vulnerable elderly and the taxpayers!
My BP hit the roof again. Leave it to NASGA to give us the real news that affects our lives, our parents lives and our futures.
Gotta love the Department of Justice when they get a case the problem is getting the OK from the higher ups to move on scams and schemes.
Let's face the facts:
It's so ***** easy to defraud Medicare and Medicaid. Yet Medicare prints up millions of NOTICEs OF NON-MEDICARE COVERAGE with instructions on jumping through hoops and loops to APPEAL their denials.
Yet, they BLINDLY approve physician billing.
I saw documentaries, news coverage where investigative reporters went to the addresses of the claimants OMG OMG nobody was there in fact the addresses were from abondoned commercial buildings -- these ***** laughed all the way to their overseas banks while we fund this racket and while the old folks are getting NOTICE OF NON-MEDICARE COVERAGE so they need to have a paralegal family member or retain a lawyer to try to get benefits for their medical situation.
Pay attention younger generation you are next!!! while funding this system that was turned into a racket. Can you see my steam?
Thank you NASGA, for sharing this story. What is so upsetting is that more than the owner knew about this. Who are the others thant knew and took part in this scheme? Glad she is in jail. I hope this sends a warning to all of the attorneys and judges out there who are getting kickbacks....you are next to go to jail...
Billy Deneca got caught defrauding Medicaid for over $1 mil. Think how much guardianship abuse is costing Medicaid. Read NASGA's "The Fleecing of Medicaid and the Taxpayer" at www.AnOpenLetterToCongress-3.info
Good initiative and government should support it fully..
Hello, good post, yeah like your post very much and give us good information about assisted living centre. Yeah it is very good and holy work. There are so many assisted living centres open Idaho, Blackfoot and in Pocatello but we should select good assisted living centre who can provide good services in reasonable costs.
Assisted living Idaho falls
Post a Comment