Miami residents get six years for $63 million mental health scheme; Massachusetts home health owner sentenced, loses house;

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> Two Miami residents were each sentenced to six years in prison for their role in a longstanding Medicare and Medicaid scheme that totaled $63 million. Blanca Ruiz and Alina Fonts were employed by Health Care Solutions Network Inc. which operated two community mental health centers in Florida. Ruiz and Fonts altered and forged medical records to support fraudulent claims, often creating medical records weeks or months after the patient's admission. In other cases, purported therapy included Disney movies and bingo games. Announcement

> The owner of a Boston-area nursing agency was sentenced to nearly eight years in prison for submitting $27 million in fraudulent home health claims to Medicare. Michael Galatis, who owned At Home VNA, trained nurses to recruit healthy patients with Medicare insurance and convinced them to enroll in home health services. Galatis then paid a physician to sign altered medical records that made it appear those patients needed those services. Galatis was ordered to pay $7 million in restitution and forfeit his $850,000 home, which was bought with proceeds from the scam. Announcement

> A national healthcare chain that operated skilled nursing facilities around the country paid $3.5 million to settle allegations that it upcoded rehabilitation therapy services. Prosecutors alleged that three New York facilities, operated by Catholic Health Care System (also known as ArchCare), inflated reimbursement amounts for unnecessary or undelivered services provided by affiliates of RehabCare Group East Inc. and Kindred Healthcare Inc. Federal agents indicated that ArchCare didn't do enough to prevent a pattern of unreasonable therapy, often billing for the highest rates of therapy reimbursement when less therapy was provided. Announcement

Health Finance News

> The largest publicly traded hospital operator, Hospital Corporation of America Inc., is the target of a whistleblower lawsuit that alleges the company provided unnecessary cardiac surgeries. The lawsuit, brought by Professional Liability Claims Director Christopher Gentile, was revealed last week after being sealed for three years. Gentile claims two chains in Florida performed unnecessary surgeries. Article

Health IT News

> Software used in the Anthem hack that comprised information for nearly $80 million consumers has been linked to the Chinese government. The same software was used in a previous attack on VAE, a defense contractor located in Virginia. China has denied involvement in the hack, but experts called the digital signature used in both cases "precise." Article

And finally… The literal interpretation of a "man cave." Article

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