Intrepid U.S.A. Inc., a Dallas-based health care and hospice provider, has agreed to pay $3.85 million for allegedly submitting Medicare claims for patients who did not qualify for coverage.
On Tuesday, the U.S Department of Justice (DOJ) alleged that between 2016 and 2021 19 Intrepid facilities submitted claims to Medicare for home health care services for patients who did not qualify or were not properly certified as eligible for the Medicare home health care benefit or where the services provided were not reasonable or medically necessary.
Claims were also allegedly submitted for services provided by untrained staff or services that were not performed.
Separately, the DOJ said that between 2016 and 2021 three Intrepid hospice facilities admitted patients who were ineligible for the Medicare hospice benefit because they were not terminally ill.
These facilities also kept providing services to patients who should have been discharged because they no longer met the requirements for the Medicare hospice benefit.
The civil settlement resolved claims brought under the whistleblower provisions of the False Claims Act in two different lawsuits.
Defendant, Co-Conspirators Agree To Pay $70M for Bribery Scheme Involving Energy Trading Firm Vitol
A defendant and seven co-conspirators have agreed to forfeit a total of $70.1 million for their roles in a scheme to bribe Mexican government officials to secure contracts for Vitol Inc., the U.S. affiliate of the largest independent energy trading firm in the world.
According to court documents, Javier Aguilar, 50, of Houston, and seven co-conspirators paid about $600,000 in bribes to two senior officials at PEMEX Procurement International, Inc. (PPI), a wholly owned affiliate of the Mexican state-owned oil company, Petróleos Mexicanos (PEMEX), in exchange for assistance in winning business for Vitol.
Between 2017 and 2020, Aguilar, who was a trader in Vitol's Houston office, and his co-conspirators obtained numerous contracts for Vitol to supply hundreds of millions of dollars of ethane to PEMEX through the bribery scheme. To conceal the scheme, Aguilar and his co-conspirators used a series of fake contracts, sham invoices and shell entities incorporated in Curacao and Mexico, the DOJ said on Thursday.
As part of his guilty plea, Aguilar consented to transfer the Texas case to New York, to consolidate the cases, and to forfeit $7,129,938. He faces a maximum sentence of 20 years imprisonment on the money laundering offense and five years imprisonment on each of the other offenses.
The seven other co-conspirators have pleaded guilty to their role in the scheme and agreed to forfeit more than $63 million in connection with this and related schemes.
Union Leaders Charged with Embezzling $20M In Dues for Luxury Travel, No-Show Jobs and Health Care Fraud
A federal grand jury in Kansas returned an indictment on Wednesday charging seven defendants, including five current and former high-level officers of the International Brotherhood of Boilermakers, Iron Ship Builders, Blacksmith, Forgers and Helpers for their alleged roles in a 15-year, $20 million embezzlement scheme.
The defendants are charged with conspiracy to commit offenses under the Racketeer Influenced and Corrupt Organizations Act (RICO), as well as other charges including embezzlement, health care fraud, wire fraud, and theft in connection with health care and retirement plans.
The defendants are former union president Newton Jones, 71, of Chapel Hill, North Carolina; former secretary-treasurer William Creeden, 76, of Kearney, Missouri; former president Truman "Warren" Fairley, 59, of Chapel Hill; current secretary-treasurer Kathy Stapp, 53, of Shawnee, Kansas; former vice president Lawrence McManamon, 76, of Rocky River, Ohio; Kateryna Jones, 32, of Chapel Hill; and Cullen Jones 35, of Chapel Hill.
Embezzlement activities, led by Jones and Creeden, allegedly included over $5 million in unnecessary luxury international travel, over $2 million in salary and benefits to Kateryna Jones and Cullen Jones for no-show jobs and millions of dollars in cash payments relating to fraudulently claimed vacation time, the DOJ said.
They also include $7 million in fraudulent loans from the Boilermakers Union MORE Fund.
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