The Beginning of the End

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Hospice provides comprehensive, professional medical care to patients who are facing a terminal illness. The service is intended to provide comfort to people facing the end of their lives, not serve as a conduit for defrauding the government. The Philadelphia Business Journal reports that a home hospice business owner used his company to bilk Medicare of $16.2 million. (That amount definitely would fund a pretty lavish lifestyle.)

The story states that the 52-year-old business owner submitted false claims to Medicare for ineligible patients or patients, who never received the level of hospice care that was billed. The owner accomplished his massive scheme by coercing his staff, rewriting nursing documentation that made his patients appear to be more ill on paper than they actually were, destroying old patient files and paying kickbacks to doctors who referred ineligible patients to the business. (Many of the company’s patients were not terminally ill and should not have received any hospice care at all.)

The story also states that the fraudster kept $7.7 million of the Medicare funds for himself. Apparently, he set up his wife as the company CEO. (She received millions in salary and bonuses, which were used to pay for extensive renovations to the couple’s house, travel expenses, college tuition and a luxury vehicle.)

The hospice business owner pleaded guilty to conspiracy to commit health care fraud, 21 counts of health-care fraud, 11 counts of money laundering and two counts of mail fraud. The criminal was sentenced to 14 years in prison and was ordered to pay $16.2 million in restitution.

Hospice is the beginning of the end for many patients and this case is proof that the government will not tolerate fraud in this area where eligible patients were denied the ability to die with dignity and in comfort. The 14-year prison sentence is the beginning of the end for this fraudster, who will be facing his golden years locked behind bars.

Source: Today’s ”Fraud of the Day” is based on an article titled, ”Bucks County Man Gets 14-years in Prison for Medicare Fraud,” written by John George and published in the Philadelphia Business Journal on May 27, 2014.

A 52-year-old Churchville man was sentenced to 176 months in prison, and ordered to pay $16.2 million in restitution to Medicare, for defrauding the government through his home hospice business.

A federal jury in October found Matthew Kolodesh, 52, or Churchville, Pa., guilty of conspiracy to commit health-care fraud, 21 counts of health-care fraud, 11 counts of money laundering, and two counts of mail fraud.

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Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.