A 46-year-old Placentia woman was sentenced Monday to a year of home detention for helping to 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.
Sharon Patrow must also pay a share of $7.4 million in restitution and serve five years on federal probation, according to the U.S. Attorney’s Office.
In granting a non-custodial sentence, U.S. District Judge S. James Otero made numerous references to Patrow’s role as sole caregiver for her adult son, who suffers from cerebral palsy.
Patrow pleaded guilty in October 2015 to a felony health care fraud count. Her mother, Priscilla Villabroza, is serving eight years behind bars for her role in the scheme.
The mother-daughter pair, along with five others, were charged in 2014 with multiple health care fraud and money laundering counts, each of which carries a potential multiple-year prison sentence.
The case involved now-defunct 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 $7.4 million on those bogus bills.
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 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