A 46-year-old Placentia woman who helped run a hospice that submitted millions of dollars in fraudulent bills to Medicare and Medi-Cal for end-of-life care for patients who were, in reality, not dying faces prison time when she is sentenced Monday.
Sharon Patrow pleaded guilty in October 2015 to a felony health care fraud count before U.S. District Judge S. James Otero. Her mother, Priscilla Villabroza, is serving eight years behind bars for her role in the $8.8 million scheme.
Prosecutors in Los Angeles are recommending that Otero sentence Patrow to 27 months in federal prison and order her to pay a share of about $7 million in restitution, court papers show.
The mother-daughter pair, along with five others, were charged in 2014 with 25 health care fraud and money laundering counts, each of which carries a potential multiple-year prison sentence, according to the U.S. Attorney’s Office.
The case involves the formerly Covina-based California Hospice Care, which Villabroza purchased in late 2007 while under investigation in an earlier case.
Prosecutors said that between March 2009 and June 2013, California Hospice submitted nearly $9 million in fraudulent bills to Medicare and Medi- Cal for purportedly providing end-of-life care to patients who were, in fact, doing well. The public health programs paid nearly $7.5 million on those bogus bills.
According to the indictment, Patrow and her mother paid patient recruiters known as “marketers” or “cappers” to bring in Medicare and Medi- Cal beneficiaries.
As part of the scheme, registered nurses at California Hospice performed “assessments” to determine whether the beneficiary was terminally ill and, regardless of the outcome, two doctors at the hospice certified that the beneficiary was dying — even though the vast majority of them were not terminally ill, prosecutors said.
They said personnel at now-defunct California Hospice altered medical records in response to Medicare audits to make the beneficiaries appear sicker. In the end, Medicare and Medi-Cal paid millions of dollars for medically unnecessary hospice-related services, according to the government.
In July, a former doctor from Anaheim was sentenced to nine years behind bars for falsely certifying that Medicare patients were terminally ill, and thus qualified for hospice care at the facility when the vast majority of them were not actually dying. Sri “Dr. J” Wijegoonaratna, 62, was also ordered to pay about $3.3 million in restitution to the federal government, according to the U.S. Attorney’s Office.
—City News Service