he owner and the CEO of a chain of Texas hospice and home-health centers defrauded Medicare out of $152 million by falsely certifying that all of their clients were either dying or too frail to go to a doctor’s office, a federal appeals court held Thursday.
The 5th U.S. Circuit Court of Appeals affirmed the health care fraud and conspiracy convictions of Merida Group owner Rodney Mesquias and CEO Henry McInnis, as well as their respective 20-year and 15-year sentences. Both men were also ordered to pay $120 million in restitution.
Mesquias and McInnis argued that their convictions were based on insufficient evidence, since physicians had certified that the patients were eligible for home-health services or hospice care. “But health care providers cannot immunize themselves from prosecution by cloaking fraud with a doctor’s note,” Circuit Judge Gregg Costa wrote for the unanimous three-judge panel.
Source: Texas hospice execs guilty of $152 million Medicare scam, U.S. appeals court holds / Reuters