A former doctor from Anaheim was sentenced Friday to nine years behind bars for falsely certifying that Medicare patients were terminally ill, and thus qualified for hospice care, 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.
Following a two-week trial in May 2016, Wijegoonaratna and another ex-doctor were found guilty of participating in a scheme related to now-defunct Covina-based California Hospice Care.
Between March 2009 and June 2013, California Hospice submitted roughly $8.8 million in fraudulent bills to Medicare and Medi-Cal for end-of-life services, and the public health programs paid out nearly $7.4 million.
Co-defendant Boyao Huang, 45, of Pasadena was sentenced in August to four years behind bars and ordered to pay about $1.3 million in restitution.
Eight others charged in connection with the scheme have pleaded guilty, including the ringleader, Priscilla Villabroza, 71, of Placentia. She was sentenced to eight years in federal prison in June 2016, and U.S. District Judge S. James Otero ordered her to pay more than $7 million in restitution.
Villabroza’s daughter, Sharon Patrow, 46, is expected to be sentenced in November.
Patrow and her mother paid patient recruiters known as “marketers” or “cappers” to bring Medicare and Medi-Cal beneficiaries to the Villabroza-owned hospice.
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, Huang and Wijegoonaratna at the hospice certified that the beneficiary was dying — even though the vast majority of them were not terminally ill.
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.
Wijegoonaratna faces sentencing in October in a separate health care fraud case, federal prosecutors said.
— City News Service