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Reap What You Sow

Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

Newly released Federal Trade Commission data show that consumers reported losing more than $10 billion to fraud in 2023, marking the first time that fraud losses have reached that benchmark. This marks a 14% increase over reported losses in 2022. The short of this report is that there is more opportunity in fraud than ever before. And fraudsters don’t care who they are scheming from. Including the dying. Shiva Akula owned and oversaw the day-to-day operations of Canon Healthcare, LLC, a hospice facility with offices in Louisiana and Mississippi. But Akula showed little or no regard for quality end-of-life hospice care. Instead, Akula’s day-today operations centered around multiple fraud schemes to maximize profit and steal from American taxpayers.

Between January 2013 and December 2019, Akula billed Medicare approximately $84 million in fraudulent claims. He was paid approximately $42 million relating to these fraudulent claims. And leaving the dying to just do that. Die without the extra care he profited from. Akula’s scheme included overbilling for expensive General Inpatient services and manipulating Medicare billing codes despite such services being medically unnecessary, or despite their inclusion in the daily hospice benefit Canon already received for its patients. It didn’t matter what the patient needed. Akula was going to charge for the most expensive code in the Medicare book and not provide the services.

On May 15, 2024, a Federal court in Louisiana sentenced Akula, to serve twenty years in prison for his involvement in health care fraud. Reap what you sow. At sixty eight years old, he will probably get less hospice care in prison than his patients did. The court also ordered Akula to repay $42 million in fraudulent Medicare billing claims.

The case was investigated by the FBI, the U.S. Department of Health & Human Services Office of Inspector General (HHS-OIG) and the Louisiana Department of Justice, Medicaid Fraud Control Unit.

Today’s Fraud of the Day is based on article “Louisiana hospice facility owner sentenced in Medicare fraud case” published by WGNO News on May 16, 2024.

A Louisiana hospice facility owner convicted of Medicare fraud was sentenced on Wednesday, May 15. According to the Office of U.S. Attorney Duane A. Evans, 68-year-old Shiva Akula was sentenced by a judge to 240 months in prison, three years of supervised release and $2,300 in mandatory fees for 23 counts of health care fraud.

Court documents state Akula oversaw Canon Healthcare, LLC, which had locations in New Orleans, Baton Rouge, Covington and Mississippi. The documents state Akula was convicted on Nov. 6, 2023, of overbilling hospice patients for General Inpatient Services and manipulating Medicare billing codes.

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