Dallas $5 million ear care scam targeting elderly part of nation’s biggest Medicare bust – Dallas Morning News (blog)

Attorney General Loretta Lynch announces the nation's biggest Medicare takedown.

Attorney General Loretta Lynch announces the nation’s biggest Medicare takedown (CNN).

Three Garland residents who are accused of running an ear care scam are among dozens arrested in multiple states as part of the nation’s biggest Medicare fraud bust.

Nine others in the Dallas area linked to three separate home health care scams also were charged.

The Medicare Fraud Strike Force investigation resulted in criminal and civil charges against 301 people nationwide, including 61 doctors, nurses and other medical professionals. In total, about $900 million was scammed from Medicare with false billings for care.

Harlan R. Hill and his wife, Latecia P. Hill, of Garland, were indicted along with her mother, Pearle L. Madere, in Dallas on 15 counts of health care fraud, court records show.

Harlan Hill (Facebook)

Harlan Hill (Facebook)

They allegedly billed Medicare for bogus ear care procedures supposedly done on elderly nursing home patients, some of whom were unconscious. The alleged scam netted the defendants more than $5.1 million.

Harlan Hill, 52, owned Total Ear Care, and Latecia Hill, 50, was the administrator who ran day-to-day operations and told employees what to do, the indictment said.

Madere, 71, also of Garland, helped run daily operations and marketed the company to nursing homes, the indictment said.

“The wrongdoers that we pursue in these operations seek to use public funds for private enrichment,” said Attorney General Loretta Lynch. “They target real people – many of them in need of significant medical care. They promise effective cures and therapies, but they provide none.”

Ear scam

Total Senior Ear Care enrolled as a Medicare provider in August 2011.

The indictment alleges the following activity.

The suspects told nursing homes the company could provide on-site ear care to elderly residents, including comprehensive evaluations by ear, nose and throat doctors.

The company’s contracted physicians and medical assistants went to the nursing homes to do a “complete sweep,” seeing every resident regardless of whether they needed hearing-related services.

Sometimes that would involve seeing as many as 100 people in one day. The doctors spent less than five minutes with most patients.

“Many of the patients ‘visited’ were unresponsive and had no way to communicate whether they wanted the service or not.”

Latecia Hill and Madere told staff that if a patient “gave an eye movement or made a sound,” they could “interpret that as consent and proceed with the exam, cleaning or ear-probe testing.”

The Hills had their employees submit bills to Medicare for face-to-face doctor visits lasting about 35 minutes during which physicians performed comprehensive exams.

‘No medical value’

But two physicians identified only by their initials in the indictment actually provided “cursory exams that had no medical value.”

“Physicians seemingly just placed an otoscope in the patients’ ear and checked to see if they had ear wax, then ordered…ear wax cleanings even if the patient did not need or want the cleaning.

Many of the patients referenced in the indictment refused services. Others “could not wake up.” One could not be located.

One of the doctors resigned in June 2014, but his “services” were billed to Medicare through August 2015.

All of the Medicare beneficiaries were diagnosed with the same condition — sensorineural hearing loss — regardless of whether it was true or not. And medical assistants provided “unnecessary hearing-related screenings.”

Latecia Hill and Madere told medical assistants, who had no training in hearing tests, to perform a screening with a device that measures pressure in the ear but doesn’t test for hearing.

The FBI seized the couple’s $400,000 Garland home along with a 2011 Mercedes-Benz and 2013 Maserati Quattraporte, which must be forfeited to the government if the defendants are convicted.

“Medicare and Medicaid fraud not only increases health care costs, but it victimizes the elderly and those who may be vulnerable,” said U.S. Attorney John Parker, of the Northern District of Texas.

Home health schemes

Elder Home Health Services in Garland also was implicated in the nationwide sweep.

The owner, Celestine “Tony” Okwilagwe, 48, and Paul Emordi, 50, a supervisor, ran the business even though they were banned from participating in federal health care benefit programs, authorities said.

Adetutu Etti, 58, an administrator, is accused of concealing that fact from Medicare and Medicaid. The indictment says Okwilagwe billed the programs more than $3.4 million in bogus claims from January 2013 to May 2016.

Hector Molina, 51, an Irving doctor who owns Molina Medical Housecall Services, also was charged in an updated indictment along with three of his employees for a separate home health care scheme. He was arrested last year.

The employees are Blanca Mata, 47, of Forney; Lidia Antonio, 56, of Irving; and George Richard Rivaux, 43, of San Antonio. Ivan Castilleja, 38, of Dallas, also was charged.

Molina was charged with 11 counts of health care fraud and one count of aggravated identity theft for for “care plan oversight,” which allegedly netted $28.6 million from January 2010 to April 2015.

Finally, physician assistant Shawn Chamberlain of Collin County, part-owner of Boomer House Calls, was charged for allegedly using a physician to bill Medicare for bogus home health visits.

Chamberlain hired a physician to apply for a Medicare number so he could use that number to sign false physician certifications indicating that people needed home health care, the indictment said.

Chamberlain provided the certifications to Timely Home Health Services, Inc. in Dallas from August 2013 to September 2015, resulting in about $1.6 million worth of false Medicare billings, according to the indictment.

Twitter: @KevinRKrause

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