[ad_1]
Henry McInnis, CEO of the Texas-based Merida Group of hospice and home health entities, has been sentenced to 15 years in prison for telling patients with long-term, incurable illnesses that they had less than 6 months to live so that the company could enroll them in hospice. The company collected more than $150 million in fraudulent Medicare payments, according to the US Department of Justice (DOJ).
Most hospice programs require that patients have a life expectancy of 6 months or less.
Trial testimony also pointed to bribes and kickbacks to physicians.
According to a DOJ press release, multiple witnesses testified that McInnis ordered employees at Merida, which has dozens of locations across Texas, to change medical records to make it appear that patients were terminally ill.
“In reality, some were employed or even participating in sporting events,” the DOJ stated.
In November 2019, a federal jury convicted McInnis, who is from Harlingen, Texas, of conspiracy to commit healthcare fraud, conspiracy to commit money laundering, obstruction of justice, as well as six counts of healthcare fraud.
His partner in the scheme, Rodney Mesquias, owner of the hospice and home health entities, was also convicted in the November 2019 trial and was sentenced to 20 years in prison in December 2020. Two other co-conspirators have pleaded guilty and are awaiting sentencing.
$150M Scheme
The scheme, which stretched from 2009 to 2018, involved the submitting of more than $150 million in fraudulent bills, falsification of medical records, and the paying of kickbacks, Acting Attorney General Nicholas L. McQuaid of the DOJ’s Criminal Division, said in a statement.
According to the press release, McInnis and his partners “directed bribes to physicians under the guise of medical director fees to certify unqualified patients for hospice and home health. In some cases, they improperly offered payoffs to marketers in exchange for recruitment of patients who could be placed on extremely expensive hospice services.”
Many of the patients whom Merida leaders preyed upon had diminished mental capacity, McQuaid said.
According to the Texas Health and Human Services Inspector General, chaplains were sent to the targeted patients to discuss last rites.
In addition to the cruelty of telling patients they had months to live, there were medical consequences as well. When the patients were enrolled in hospice, curative measures stopped.
Special Agent in Charge Miranda L. Bennett, with the US Department of Health and Human Services Office of Inspector General, said in a statement, “McInnis and his co-conspirators’ reprehensible and deceitful actions to defraud Medicare weren’t without harm: vulnerable beneficiaries were unnecessarily enrolled in hospice care, preventing them from accessing needed curative care.”
According to the DOJ, McInnis had no medical training. He was previously employed as an electrician. He acted as the de facto director of nursing for the Merida Group.
Witnesses at the trial testified that McInnis instructed employees to admit unqualified patients to hospice and home healthcare and to provide services to unqualified patients for long periods. He fired and reprimanded employees who refused to participate in the scheme.
Witnesses said the employees were told that the actions were needed so that the Merida Group could pass insurance company audits.
According to a December 16 press release from the US Attorney’s Office in the Southern District of Texas that announced the sentencing of Mesquias, McInnis and Mesquias used the extra funds to buy luxury vehicles, clothing, jewelry, real estate, sporting event tickets, and security services.
The two “also treated physicians to lavish parties at these elite nightclubs, providing them with tens of thousands of dollars in alcohol and other perks in exchange for medically unnecessary patient referrals,” the press release states.
Marcia Frellick is a freelance journalist based in Chicago. She has previously written for the Chicago Tribune and Nurse.com and was an editor at the Chicago Sun-Times, the Cincinnati Enquirer, and the St. Cloud (Minnesota) Times. Follow her on Twitter at @mfrellick.
For more news, follow Medscape on Facebook, Twitter, Instagram, and YouTube.
[ad_2]
Source link
