January 26, 10

NEWS / Physical Therapist Pleads Guilty in Connection with Detroit Home Health Care Fraud Scheme

Detroit-area resident Jessica Vigil pleaded guilty today for her role in a Detroit-area home health care fraud scheme, announced Assistant Attorney General Lanny Breuer of the Criminal Division; U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade; Special Agent in Charge Andrew G. Arena of the FBI’s Detroit Field Office; and Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services, Office of the Inspector General’s (HHS-OIG) Chicago Region.

Vigil, 34, pleaded guilty today to one count of conspiracy to commit health care fraud before U.S. District Court Judge Denise Page Hood of the Eastern District of Michigan. At sentencing, scheduled for May 27, 2010, Vigil faces a maximum sentence of 10 years in prison and a $250,000 fine.

According to plea documents, Vigil, a licensed physical therapist, admitted that she began working in approximately September 2008 as a therapist at All American Home Care Inc., and associated entities (All American). All American purported to provide home health services to Medicare beneficiaries in the Detroit area, including physical and occupational therapy services. Vigil admitted that she and other co-conspirators created fictitious therapy files, appearing to document physical and occupational therapy services provided to Medicare beneficiaries, when in fact no such services had taken place.

Vigil admitted that her role in the conspiracy was to sign documents, including start of care packages, recertification forms and discharge papers that facilitated All American’s ability to bill Medicare for home health visits. These documents allowed All American to commence, continue or conclude the purported treatment of patients and the Medicare billing cycle. Vigil admitted that she was paid between $80 and $100 by the owners of All American for each form she signed. In total, Vigil was paid more than $127,000 for signing the forms. In the course of the scheme charged in the indictment, Vigil signed documents used to justify approximately $2.375 million in home health claims paid by Medicare to All American for patients Vigil either never saw or for whom home health services were medically unnecessary. Vigil admitted that she knew the files she helped falsify were used to justify fraudulent billings to Medicare.

This case is being prosecuted by Senior Trial Attorney John K. Neal and Trial Attorney Gejaa T. Gobena of the Criminal Division’s Fraud Section. The case is being investigated by the FBI and the HHS Office of the Inspector General (HHS-OIG). The case was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan.

Since their inception in March 2007, Strike Force operations in seven districts have obtained indictments of more than 500 individuals who collectively have falsely billed the Medicare program for more than $1 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

http://www.justice.gov/opa/pr/2010/January/10-crm-083.html

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