Acting U.S. Attorney Duane A. Evans announced that LISA CRINEL age 52; of New Orleans, and PCAH, INC. a/k/a PRIORITY CARE AT HOME, INC. d/b/a ABIDE HOME CARE SERVICES INC. (“ABIDE”), were sentenced today for their roles in approximately $30,052,295 in Medicare fraud.
U.S. District Judge Susie Morgan sentenced CRINEL to 80 months imprisonment, followed by three years of supervised release, and restitution to Medicare in the amount of $16,088,222. The corporation CRINEL owned, PCAH, INC. a/k/a PRIORITY CARE AT HOME, INC. d/b/a ABIDE HOME CARE SERVICES INC., was sentenced today to five years of probation and restitution to Medicare in the amount of $16,088,222.
On March 12, 2015, CRINEL and ABIDE were indicted along with 19 other defendants in a 26-count indictment.
On October 2, 2015, CRINEL pled guilty to one count of conspiracy to commit healthcare fraud and one count of conspiracy to pay and receive illegal kickbacks. That same day, ABIDE pled guilty to one count of conspiracy to commit health care fraud.
According to court documents, CRINEL was the owner and operator of ABIDE, a business that provided home health care services to homebound individuals who were primarily Medicare beneficiaries. As the owner and Chief Operating Officer of ABIDE, CRINEL took a “100 percent hands on approach” that extended to “almost every aspect of the operation” of the business. Home health experts trained CRINEL and her staff on who qualified for home health and how home health services should be documented. Evidence seized at the search of ABIDE’s office established that CRINEL maintained ABIDE’s Medicare Provider Number and routinely certified on behalf of ABIDE that she would not knowingly present or cause to be presented false or fraudulent claims for payment by Medicare. Nevertheless, CRINEL instructed her staff not to discharge patients, even those who did not require home health services. ABIDE, under CRINEL’s direction, also routinely falsified diagnoses codes and medical records to cause inflated reimbursements from Medicare. CRINEL and ABIDE created an atmosphere where nurses and other healthcare professionals would compromise their medical and ethical judgment in order to defraud Medicare. Court documents also show that CRINEL and ABIDE entered into sham employment contracts and medical director contracts with doctors and others to cover up the illegal kickback relationship between CRINEL, ABIDE, and those doctors and other individuals. Four physicians have since been convicted for their roles in the conspiracies and are awaiting sentence.
Acting U.S. Attorney Evans praised the work of the Special Agents of the Federal Bureau of Investigation and the U.S. Department of Health and Human Services in investigating this matter. Assistant U.S. Attorneys Patrice Harris Sullivan, Hayden M. Brockett, Sharan Lieberman, and Maria Carboni were in charge of the prosecution.