The owner of a Texas home health agency has been sentenced to 45 months in prison and ordered to pay more than $1 million in restitution for Medicare fraud.
The U.S. Attorney’s Office in the Southern District of Texas said Miguel Angel Contreras submitted false and fraudulent claims to Medicare for health services that were never provided by McAllen, TX-based Sambritt Home Health LLC and had never been authorized by a physician. Contreras submitted claims to Medicare totaling more than $724,000. As a result of the false and fraudulent claims, Medicare paid approximately $1.04 million.
Contreras also admitted paying illegal kickbacks in exchange for patient information, including the Medicare numbers of patients. He and his co-conspirators would then use the information to submit claims to Medicare in order to receive reimbursements.
As part of his plea, Contrers admitted forging or encouraging others to forge the signatures of physicians on 485 referral forms, knowing the physicians did not authorize home home health services or that beneficiaries did not qualify for them. He also directed employees to create so-called ghost notes for patients, which were intended to make fraudulent claims to Medicare appear legitimate.
The U.S. Department of Health and Human Services Office of Inspector General, the Federal Bureau of Investigation assisted in prosecuting the case.
