Compliance News Roundup: Ambulance Swapping and a 8.6 Million Dollar Settlement

1. McDonough woman pleads guilty to Medicaid fraud, ordered to pay $3.8 million – “The owner of a former Henry County mental health services business will have to pay $3.8 million in restitution to the Georgia Medicaid Program for alleged Medicaid fraud. Casandra Jones, 47, of McDonough and Frederick Thrasher owned and operated House of Preparation, which purported to provide mental health services to youth and adults. On Monday, Oct. 2, Jones pleaded guilty midway through her trial to one count of Medicaid fraud, one felony count of conspiracy to defraud the state and two felony counts of forgery in the second degree.” Get the full scoop >>

2. Former CEO of Benchmark Healthcare Sentenced on Health Care Fraud Charges – “John Mac Sells, 53, of St. Peters, Missouri, was sentenced today to 41 months in prison and ordered to pay $667,201.85 in restitution. According to court documents, between 2013 and 2016, John Sells was the chief executive officer (CEO) of Benchmark Healthcare of Festus, Inc. (Benchmark), and a number of long-term care facilities in Missouri, Kentucky and Tennessee. Sells stole the funds provided by Medicaid which he was to use to provide care for elderly and disabled residents at Benchmark. Because of Sells’ diversion of funds to his own use, the residents did not receive medication, food, and needed dietary supplements. On one occasion, the residents were only given a clear bowl of broth soup and a very small cookie. Another meal consisted of 1-2 ounces of lunchmeat, half of a baked potato, and a small muffin. Neither of these meals was substantial and did not meet the nutritional needs of the residents. On some occasions, Benchmark staff had to use their own money to buy food when there was no or inadequate food at the facility.” Get the full scoop >>

3. Deeper Than The Headlines: Ambulance Swapping and a 8.6 Million Dollar Settlement – “Recently, four Texas hospitals associated with the Hospital Corporation of America (HCA) settled for $8.6 million dollars. What is interesting about this settlement is that the DOJ made sure to hold the medical institutions accountable for their role in receiving the alleged kickbacks and didn’t just focus on the ambulance companies themselves.” Get the full scoop >>