When fraud becomes a family affair

Sometimes healthcare fraud is a family event where people involved in scams conspire with or victimize their nearest and dearest.

Case in point: A federal jury in Virginia convicted a husband and wife on numerous fraud-related counts, according to the Department of Justice.

W. Wayne Perry, Jr. and his wife Angela owned and operated Community Personal Care, a provider of home health services. From 2009 to 2012, the couple filed fraudulent claims of approximately $1.3 million with Virginia Medicaid, falsely representing that their company rendered personal and respite care to beneficiaries. To hide the fraud, the Perrys altered time sheets and other documentation.

And in Florida, father and daughter owners of a home care company recently settled Medicare fraud allegations with the federal government for $1.65 million, the Justice Department announced. Family involvement in this case was double nested, since both the alleged perpetrators and participants were related.

Stephen and Tracy Nemerofsky and their company, A Plus Home Health Care, Inc., were accused of executing a false marketing scheme by paying spouses of referring doctors to serve in bogus marketing positions in exchange for patient referrals.

The company reportedly hired at least seven physicians' spouses and one doctor's boyfriend to perform marketing tasks; but these employees did little--if any--real work, the Department noted. Instead, their paychecks were allegedly an incentive and reward for doctors' referring patients to A Plus. Tracy Nemerofsky reportedly fired at least two spouses whose husbands didn't come through with enough referrals, according to the announcement.

Finally, estimates indicate that one-third of all identity theft is committed against the thieves' own family members, Fraud Avengers noted, with children particularly vulnerable to criminal acts of parents. Further, the Identity Theft Resource Center noted that as much as 43 percent of the identity theft they track is medically-related, as FierceHealthPayer: AntiFraud has reported. And more than half of medical identity theft is "friendly fraud," where an uninsured person uses a relative's insurance identification card to access healthcare services, according to United Credit Service, Inc.

For more:
- read the Justice Department announcements on the Perrys and Nemerofskys
- here's the Fraud Avengers article