Health Care Fraud charges filed against north randall company and owner
A man who lives in Orange, Ohio and his home health care company were indicted on a six counts related to overbilling Medicaid and Medicare by more than $2.5 million and knowingly employing a worker who had previously been convicted of health-care fraud, said Steven M. Dettelbach, United States Attorney for the Northern District of Ohio.
Divyesh C. Patel, a.k.a. David Patel, age 38, and his home health care company, Alpine Nursing Care, Inc., located at 4753 Northfield Road, Suite 5, North Randall, Ohio, were each charged with one count of conspiracy to commit health care fraud, four counts of health care fraud, and one count of making a false statement related to a health care benefit plan.
“This defendant enriched himself and his company by flouting rules designed to protect the public,” Dettelbach said. “The indictment details forged signatures and services that were never provided or performed by aides with criminal records, among other violations.”
The indictment alleges that Patel and Alpine employed Belita Mable Bush, a.k.a. Bea Bush as the office manager and director of provider services from June 1, 2006 through October 18, 2009.
The indictment further charges that in this position, Patel and Alpine employed Bush to prepare and submit the billings to Medicaid and Medicare for reimbursement for services provided by Alpine as a home health care provider, even though Patel knew that Bush had been previously convicted of a health care-related felony that excluded Bush from being involved in any way with Alpine’s Medicaid and Medicare billings.
The indictment also alleges that in addition to the fact that Bush was excluded from handling Alpine’s medical billings, Patel and Alpine were aware that Bush falsified documents related to health care services allegedly provided to home health patients where the services were never provided, or were provided by home health aide that had previous criminal convictions that excluded them from providing health services in people’s houses.
As a result of the conspiracy, Medicaid and Medicare suffered a loss of approximately $2,564,392, according to the indictment.
Finally, the indictment alleges that Patel lied to the agents from United States Department of Health and Human Services, Office of Inspector General and the Federal Bureau of Investigation when he was interviewed regarding Alpine’s employment of Bush and his knowledge of the federal health care exclusion.
If convicted, the defendants’ sentence will be determined by the Court after review of factors unique to this case, including any prior criminal record, the defendants’ role in the offense, and the characteristics of the violation. In all cases, the sentence will not exceed the statutory maximum and, in most cases it will be less than the maximum.
This case is being prosecuted by Assistant U.S. Attorney Mark Bennett and Special Assistant General Constance Nearhood, following an investigation by the Office of the Inspector General, Department of Health and Human Services, Cleveland, Ohio; Ohio Attorney General’s Office, Medicaid Fraud Control Unit; and the Federal Bureau of Investigation, Cleveland, Ohio.
An indictment is only a charge and is not evidence of guilt. A defendant is entitled to a fair trial in which it will be the government’s burden to prove guilt beyond a reasonable doubt.