Recent news has been released by the Department of Justice (DoJ), as it relates to the sentencing of executives with a once, flourishing home health and hospice organization. The DoJ has provided a press release.

In the release, it identifies, “A corporate executive [to be} ordered to prison after his conviction related to falsely telling thousands of patients with long-term incurable diseases, such as Alzheimers and dementia, they had less than six months to live and subsequently enrolling them in hospice programs.”

“A federal jury in McAllen convicted Rodney Mesquias, 48, San Antonio. The one-month trial in November 2019 was one of the first criminal hospice fraud prosecutions the Department of Justice has presented to a federal jury. “

On December 16, 2020, “U.S. District Court Judge Rolando Olvera ordered Mesquias to serve a total of 240 months in federal prison and to pay $120 million in restitution.”

“Mesquias and his co-conspirator Henry McInnis, 48, were both convicted of one count each of conspiracy to commit health care fraud, conspiracy to commit money laundering and conspiracy to obstruct justice as well as six counts of health care fraud. Mesquias was separately convicted on one count of conspiracy to pay and receive kickbacks.”

“From 2009 to 2018, Mesquias and McInnis engaged in a scheme that involved $150 million in false and fraudulent claims for hospice and other health care services. Mesquias owned and controlled the Merida Group, a large health care company that operated dozens of locations throughout Texas. McInnis was Merida Group’s CEO. “

We are not surprised by the investigation or the sentencing. This seems to be a widespread concern throughout the United States, but more specifically, along the southern border of Texas.

Many times, the medical care, along the southern border (in our opinion) is already limited by ability to obtain insurance and other factors. The need to be vigilant for this type of conduct is crucial.

How to report Medicare fraud (copied directly from the website):

You can report suspected Medicare fraud by:

• Calling us at 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.
• If you’re in a Medicare Advantage Plan, call the Medicare Drug Integrity Contractor (MEDIC) at 1-877-7SAFERX (1-877-772-3379).
   

Have this information before you report fraud:

• Your name and Medicare Number.
• The provider’s name and any identifying information you may have.
• The service or item you’re questioning and when it was supposedly given or delivered.
• The payment amount approved and paid by Medicare.
• The date on your Medicare Summary Notice or claim.