A 50-year-old health care executive from Simi Valley was arrested this week and charged with health care fraud, federal authorities announced April 2.
The Simi Valley man’s case was part of series of fraud investigations of Southern California hospice care businesses and health-care related services that authorities say defrauded the nation’s health care system of $50 million, according to an April 2 U.S. Department of Justice news release. He is one of eight people taken into custody this week as part of nine separate cases.
The Simi Valley executive was taken into custody March 31 and made his initial appearance in U.S. District Court in downtown Los Angeles the same day, justice officials said. He was released on $10,000 bond.
Six more people were arrested April 2 and were expected to appear in the same Los Angeles courthouse later in the day. The eighth defendant was slated to make his initial appearance in U.S. District Court in Idaho, federal officials said.
Simi Valley hospice care business flagged
Federal prosecutors said that in 2022, the Simi Valley business’ discharge rate of patients before death was more than 75%, a much higher rate than the national average of around 17% the same year.
From an audit examining 18 claims made of the hospice care business between August 2023 to March 2024, the Centers for Medicare & Medicaid Services “determined the company had a pattern and practice of submitting claims that failed to meet Medicare’s hospice standards and requirements,” the release adds.
The Simi Valley executive allegedly also forged the signature of at least one physician on the Medicare enrollment forms, the release says.
During the suspected scheme, the business billed Medicare over $580,000 and was paid more than $526,000, the release says. The Simi Valley hospice business had its Medicare enrollment revoked in August 2024.
The U.S. Department of Health and Human Services, Office of Inspector General is investigating the case, the release says.
This article originally appeared on Ventura County Star: Simi Valley hospice care owner faces federal fraud charges
Reporting by Staff reports, Ventura County Star / Ventura County Star
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