The recent movie on Netflix, I Care A Lot, features the actress Alicia Witt playing the corrupt Dr. Karen Amos, who finds unsuspecting patients and connects them to a crooked legal guardian named Marla Grayson, played by Rosamund Pike. Marla compensates Karen with stock options for her part in the conspiracy in the fictional scheme, which involved sending otherwise healthy geriatric patients to nursing homes because they were supposedly unable to care for themselves.
Now comes word of a real-life criminal case involving a conspiracy to commit healthcare fraud that is equally outrageous. According to the Department of Justice, the CEO of a Texas-based company called Novus and Optimum Health Services has pleaded guilty to a $60 million scheme in which his company billed Medicare and Medicaid hospice patients for fraudulent services. According to the U.S. Attorney’s Office, Bradley Harris, a CPA, scammed the federal healthcare programs out of millions of dollars by accessing patients’ confidential medical information to recruit hospice patients. He then sent people to pose as insurance agents who induced patients to sign paperwork that would allow Novus to bill for hospice services.
In addition to the fraudulent billing, Harris also admitted to paying doctors to certify patients as terminally ill without examining them and providing blank signed prescriptions that Harris used to obtain and distribute controlled substances. For their services, the doctors were paid $150 per certification. It boggles the mind that educated, well-compensated, and otherwise intelligent physicians would risk losing their medical licenses and going to prison for $150.
How can a scenario like “I Care A Lot” happen in real life?
In plea papers, Harris admitted to crimes that occurred between 2012 and 2016 and involved at least ten other co-conspirators. According to FBI Dallas Special Agent in Charge Matthew DeSarno, “In addition to causing fraudulent billing for tens of millions of dollars, Mr. Harris preyed upon patients and families that did not have a true understanding of Novus and hospice services. The core of the company was rooted in deception, and the lack of physician oversight allowed Mr. Harris to make medical decisions for his own financial benefit.” So far, 16 defendants have been charged in the case; Harris faces up to 14 years in federal prison when he is sentenced on August 3rd.
As far-fetched as this scheme in Texas was, perhaps stranger than fiction, no doubt there are other schemes currently happening that haven’t yet been investigated. Let’s hope that scammers see this news and realize that the penalties aren’t worth the risk.
Taking advantage of hospice and nursing home patients for personal gain are major crimes and must be prosecuted to the full extent of the law.
Attorney Wendy York of York Law Firm specializes in prosecuting elder abuse, nursing home abuse and wrongful death cases in California. If you or a loved one is in need of legal services please contact Wendy York today.