U.S. District Judge S. James Otero this week sentenced a doctor from Pasadena to four years in prison for certifying that 79 patients were qualified for hospice care because they were terminally ill and defrauding Medi-Cal and Medicare, officials said.
The vast majority of them were not dying.
The judge also ordered Boyao Huang, 43, to pay $1.3 million in restitution, according to authorities.
After a two-week trial in May, Huang was found guilty of four counts of health care fraud for participating in a scheme related to the Covina-based California Hospice Care.
Between March 2009 and June 2013, CHC submitted approximately $8.8 million in fraudulent bills to Medicare and Medi-Cal for hospice-related services, and the public health programs paid nearly $7.4 million to CHC.
A second doctor who was convicted at trial – Sri Wijegoonaratna, known as Dr. J., 61, of Anaheim, who was found guilty of seven counts of health care fraud – is scheduled to be sentenced by Judge Otero on February 13, 2017.
“This scheme preyed upon dozens of patients and their families who were led to believe that their worst nightmare had come true – that they had life-ending illnesses,” said U.S. Attorney Eileen M. Decker. “Criminals such as the defendants in this case who steal from taxpayers by defrauding the Medicare system and who victimize vulnerable individuals like medical patients deserve significant prison sentences.
In addition to the two doctors, eight other defendants were charged in the scheme and have pleaded guilty to health care fraud charges.
Those other defendants include a Placentia woman who purchased California Hospice Care in 2007 and operated the facility after being charged and incarcerated in another health care fraud scheme, according to officials.
Priscilla Villabroza, 70, who pleaded guilty in December 2015 to one count of health care fraud, was sentenced in June to eight years in federal prison.
As part of the California Hospice Care fraud scheme, Villabroza and her daughter – who was the nominal owner while Villabroza was in custody – paid patient recruiters known as “marketers” or “cappers” to bring in Medicare and Medi-Cal beneficiaries, officials said.
Hospice Care nurses performed “assessments” to find out whether the beneficiaries were terminally ill. Regardless of the outcome, Wijegoonaratna and Huang certified that the beneficiaries were terminally ill – even though the vast majority of them were not dying.
Hospice Care personnel altered medical records in response to Medicare audits to make the beneficiaries appear sicker.
By the time the scheme was shut down in June 2013, Medicare and Medi-Cal had paid millions of dollars for medically unnecessary hospice-related services.
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