THREE
PEOPLE INDICTED FOR DEFRAUDING MEDICARE THROUGH BILLING SCHEME;
ONE ARRESTED AND TWO WANTED BY FBI
Two
of three people indicted earlier this month for their roles
in the operation of a fraudulent Medicare billing scheme at
a Rancho Palos Verdes agency are currently being sought by the
FBI, announced J. Stephen Tidwell, Assistant Director in Charge
of the FBI in Los Angeles.
On
May 9, 2007, a federal grand jury in Los Angeles returned an
indictment charging Lualhati Colgrove, 58, of Rancho Palos Verdes;
Albert Ulit, 47, of Lomita; and Merlinda Soreno, 58, (address
unknown), with multiple counts of health care fraud. According
to the indictment, the scheme to defraud Medicare involved the
illegal recruitment of Medicare beneficiaries and the fraudulent
billing of services which were not necessary or were never provided
by United Life Home Health, a home health care agency operated
by defendant Colgrove. The indictment also charges Colgrove
with multiple counts of illegal remuneration and the unlawful
employment of illegal aliens.
Between
January 2002 and December 2004, United Life Home Health, Inc.
was paid in excess of $9 million by Medicare, the federally
funded national health care benefit program, which reimburses
providers for certain types of medically necessary treatment.
Among treatments which qualify for Medicare reimbursement are
home health services provided by qualified home health agencies.
During
the conspiracy, United Life allegedly billed Medicare for home
health services to Medicare beneficiaries who were visited by
unlicensed nurses, as well as those who did not receive all
of the reported home health services.
United
Life nurses and employees would falsify required forms to make
it appear as though the beneficiaries were confined to the home
or otherwise needed skilled nursing and therapy services. In
some cases, patients were reported to be suffering from conditions
that did not exist, according to the indictment.
In
order to find patients, defendant Colgrove and others working
for her at United Life would pay marketers, including nursing
registries that act as marketers, to recruit Medicare beneficiaries
who were willing to sign up for home health services at United
Life. The marketers allegedly induced Medicare beneficiaries
to accept home health services and to sign paperwork by offering
cash and free dietary supplements or other goods and services.
The
indictment also alleges that defendant Colgrove knowingly employed
illegal aliens, such as defendant Soreno, who did not have authorization
to work in the United States, nor the required nursing licenses
to make patient visits.
Defendant
Soreno and other unlicensed nurses would make visits to United
Life patients but would not sign the nursing notes reflecting
their visits. Instead, defendants Colgrove, Ulit, and other
properly licensed nurses at United Life would falsify nursing
notes to indicate that they made the patient visits themselves,
when they had not in fact done so.
Colgrove
was arrested on May 14th at her residence in Rancho Palos Verdes
and has since posted bail and is awaiting trial. Soreno and
Ulit have not been located and are currently being sought by
the FBI. Photographs of Soreno and Ulit are being released to
the media. Anyone with information as to the whereabouts of
Ulit or Soreno is urged to contact their local FBI office. In
Los Angeles, the FBI can be reached 24 hours a day at 310 477-6565.
This
matter is the subject of an ongoing investigation by the FBI's
Los Angeles Field Office. The charges against Colgrove, Soreno
and Ulit are being prosecuted by the United States Attorney's
Office in Los Angeles.