In what is certainly a cautionary tale to any in home care operating outside of federal regulation, comes this post from Attorney Paul Shaw of Verrill Dana, LLP on the sentencing Friday at the federal courthouse in Boston:
Michael Galatis, 63, a registered nurse, and the owner of At Home VNA (AHVNA), a home health agency located in Waltham, was sentenced yesterday in federal district court to serve 92 months in prison for fraudulently billing millions of dollars of services to Medicare and then laundering the proceeds.
In addition to the 92 month prison sentence, U.S. District Court Judge Douglas P. Woodlock ordered Galatis to pay a $50,000 fine, $7 million in restitution to Medicare, and to forfeit proceeds of the fraud scheme, including his house, valued at $850,000. Galatis was convicted following a 16-day trial in December 2014 of conspiracy to commit health care fraud, ten counts of health care fraud, and seven counts of money laundering. From 2006 to 2012, Galatis submitted more than $27 million in false and fraudulent home health care claims to Medicare. Medicare paid AHVNA more than $20 million of those fraudulent claims.
The Medicare program pays for home health services only if the services are medically necessary and the individual is homebound. Galatis ignored these requirements and trained AHVNA nurses to recruit healthy individuals with Medicare insurance who lived in large apartment buildings. Galatis held “wellness clinics” at these buildings where nurses convinced senior citizens to enroll with AHVNA and have a nurse visit them in their home. Galatis trained AHVNA nurses to manipulate the patients’ Medicare assessment forms to make it appear as though the patients qualified for Medicare home health services, when that was often not the case. Galatis paid a physician, Dr. Spencer Wilking, to sign the home health care orders, even though Dr. Wilking did not examine the vast majority of AHVNA’s patients. Evidence at trial revealed the patients’ primary care physicians did not refer the patients to AHVNA and were unaware that AHVNA was sending nurses to see their patients in their homes.