A California doctor pleaded guilty Thursday to filing a false tax return and admitted to participating in a Medicare and Medi-Cal fraud scheme, according to the U.S. Department of Justice.
While working at a Los Angeles-area hospital between 2008 and 2012, Ovid Mercene admitted homeless patients who had been referred from an alleged "care consortium," did not require hospitalization, and underwent unnecessary tests and skilled nursing facility transfers.
Mercene billed Medicare and Medi-Cal more than $1.8 million for unnecessary services provided to the homeless patients. Mercene also hauled in about $700,000 in kickbacks for admitting Skid Row patients to skilled nursing facilities for care they did not need, and he did not report those funds on his tax returns, according to the DoJ.
Mercene admitted in court that the homeless patients arrived by van from Skid Row and stayed on a special floor away from the hospital's "regular" patients. The Skid Row patients also enjoyed smoking breaks despite supposed respiratory diseases, the DoJ noted.
California is no stranger to healthcare fraud schemes involving homeless "patients." For example, Pacific Health Corporation suspended services at its three remaining hospitals in April due to past legal issues, which included its $16.5 million settlement with the U.S. Department of Health & Human Services for defrauding Medicare and Medi-Cal by "recruiting" homeless people to act as patients and receive unnecessary treatment, for which its hospitals submitted claims, FierceHealthcare previously reported.
And in Massachusetts, UMass Memorial Medical Center agreed this summer to pay the state $66,000 to settle allegations it improperly sent bills for uninsured patients to a homeless shelter so it could then submit the charges to a state program for payment, according to FierceHealthPayer.
To learn more:
- read the DoJ announcement