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FBI: South Jersey Doctor Admits Making Half-a-Million Dollars in Fraud Scheme Involving Home Health Care for Elderly Patients 

5/9/2013

 
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TRENTON, NJ—A physician who was the owner and founder of Visiting Physicians of South Jersey—a Hammonton, New Jersey provider of home-based physician services for seniors—pleaded guilty today for charging lengthy visits to elderly patients that they did not receive, U.S. Attorney Paul J. Fishman announced.

Lori Reaves, 52, of Waterford Works, New Jersey, entered her guilty plea to an information charging her with one count of health care fraud before U.S. District Judge Freda L. Wolfson in Trenton federal court. During her guilty plea, Reaves admitted lying in Medicare billings about the amount of face-to-face time she spent with patients, which led to her receiving at least $511,068 in criminal profits. Reaves was the highest-billing home care provider among the more than 24,000 doctors in New Jersey from January 1, 2008 through October 14, 2011, according to court documents.

“Today, Lori Reaves, a South Jersey physician, admitted intentionally overbilling Medicare and pocketing more than half a million dollars she didn’t earn,” U.S. Attorney Fishman said. “The Medicare system depends on doctors and other medical professionals truthfully billing for services they actually provide. Here, Dr. Reaves chose to lie about the major service she was providing to her homebound, elderly patients: her time.”
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Reaves routinely billed Medicare using codes that would have required her—under Medicare regulations and depending on the corresponding service—to spend between 60 and 150 minutes with a patient. Many of the claims Reaves submitted would have required her to spend a minimum of two-and-a-half hours of face-to-face time with her elderly clients, when she actually spent far less. As a result, Medicare reimbursed Reaves more than $511,068 for the fraudulent prolonged service visits Reaves claimed to have made.

Reaves faces a maximum potential penalty of 10 years in prison and a fine of the greatest of $250,000 or twice the gross gain or loss caused by her offense. She will also be required to forfeit the proceeds of her crime. Sentencing is currently scheduled for July 13, 2013.  

Read the rest of the press release at FBI.gov



www.essayontime link
6/26/2013 09:28:48 pm

I am so happy to read this. This is the kind of manual that needs to be given and not the random misinformation that's at the other blogs. Thanks for sharing

Urgent care Florida link
7/17/2013 12:03:33 am

You are right but Home health care is designed to meet these needs by offering personalized service in the convenience of a patient's home. One of the most important goals of health care is ensuring that ill, elderly, and disabled patients receive high quality, personal, and compassionate care.


Comments are closed.

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    Mike and Nancy are independent consultants and coding educators.  They are a mother/son team who are active in local and regional professional organizations.

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