Massachusetts nurse pleads guilty in $100M fraud scheme

A Massachusetts nurse has pleaded guilty in federal court in Boston in connection with a $100 million healthcare fraud scheme, the Justice Department announced Sept. 13. 

Winnie Waruru, a licensed practical nurse, pleaded guilty Sept. 8 to conspiracy to commit healthcare fraud, healthcare fraud – aiding and abetting, conspiracy to pay and receive kickbacks, making false statements and making a false statement in a healthcare matter. 

Ms. Waruru was employed by Chelmsford, Mass.-based Arbor Homecare Service. She was charged in February 2021 alongside Faith Newton, who was part owner and operator of the home healthcare company from 2013 to 2017. Ms. Newton has pleaded not guilty, according to the Justice Department. 

Prosecutors allege that the duo used Arbor to defraud MassHealth and Medicare of at least $100 million by committing fraud and paying kickbacks to get referrals. Specifically, prosecutors allege that Arbor billed payers for home health services that were never provided or weren’t medically necessary. Arbor billed MassHealth for Waruru’s skilled nursing visits, many of which she did not perform, according to the Justice Department. 

Ms. Waruru is slated to be sentenced in January.

Executives, physicians at Texas hospital sentenced in $200M scheme

Kickback Definition

Fourteen defendants have been sentenced to more than 74 years in prison combined and ordered to pay $82.9 million in restitution for their roles in a $200 million healthcare scheme designed to get physicians to steer patients to Forest Park Medical Center, a now-defunct hospital in Dallas, the U.S. Justice Department announced March 19. 

More than 21 defendants were charged in a federal indictment in 2016 for their alleged involvement in a bribe and kickback scheme that involved paying surgeons, lawyers and others for referring patients to FPMC’s facilities. Those involved in the scheme paid and/or received $40 million in bribes and kickbacks for referring patients, and the fraud resulted in FPMC collecting $200 million. 

Several of the defendants, including a founder and former administrator of FPMC, were convicted at trial in April 2019 and sentenced last week. Other defendants pleaded guilty before trial.  

Hospital manager and founder Andrew Beauchamp pleaded guilty in 2018 to conspiracy to pay healthcare bribes and commercial bribery, then testified for the government during his co-conspirators’ trial. He admitted that the hospital “bought surgeries” and then “papered it up to make it look good.” He was sentenced March 19 to 63 months in prison. 

Wilton “Mac” Burt, a founder and managing partner of the hospital, was found guilty of conspiracy, paying kickbacks, commercial bribery in violation of the Travel Act and money laundering. He was sentenced March 17 to 150 months in prison. 

Four surgeons, a physician and a nurse were among the other defendants sentenced last week for their roles in the scheme. Access a list of the defendants and their sentences here

Ex-California hospital CEO will admit new charges related to $950M fraud scheme

https://www.beckershospitalreview.com/legal-regulatory-issues/ex-california-hospital-ceo-will-admit-new-charges-related-to-950m-fraud-scheme.html

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Michael Drobot, former owner and CEO of Pacific Hospital in Long Beach, Calif., is currently imprisoned for his role in a kickback scheme, and prosecutors say he has now agreed to plead guilty to new charges.

Mr. Drobot pleaded guilty to charges of conspiracy and paying illegal kickbacks in 2014. He admitted paying millions of dollars in bribes to physicians in exchange for referring thousands of patients to his hospital for spinal surgeries. He was one of several defendants charged for their roles in the kickback scheme, which resulted in the submission of more than $950 million in fraudulent claims.

In January 2018, Mr. Drobot was sentenced to more than five years in prison and ordered to forfeit $10 million to the government, which included the profits from the sale of a 1965 Aston Martin, a 1958 Porsche and a 1971 Mercedes-Benz. Federal prosecutors allege Mr. Drobot violated the order by transferring the Aston Martin to an auction company. Profits from the sale of the vehicle were allegedly transferred to Mr. Drobot’s personal bank account and used for personal expenses, according to MyNewsLA.com.

Prosecutors charged Mr. Drobot with wire fraud, engaging in monetary transactions in property derived from unlawful activity and criminal contempt of court. He is expected to plead guilty to the new charges, which carry a maximum sentence of 50 years, in coming weeks, according to the report.