On January 25, 2010, the Department of Justice announced that Jessica Vigil, a Detroit area physical therapist, pled guilty to her role in a home health care fraud scheme based in Detroit. According to plea documents, the physical therapist admitted that she and other co-conspirators created fictitious therapy files appearing to document physical and occupational therapy services provided to Medicare beneficiaries when no such services had actually taken place. The physical therapist admitted that her role was to sign documents including start of care packages, recertification forms and discharge papers that facilitated All American Homecare to bill Medicare for home health visits. She admitted that she knew the files she helped falsify were used to justify fraudulent Medicare billings and that she was paid between $80 to $100 by the owners of All American for each form she signed. In total, she admitted that she was paid more than $127,000 for signing the forms which were used to justify approximately $2.375 million in home health care claims paid by Medicare to All American for patients that the physical therapist either never saw or for whom healthcare services were medically unnecessary. http://www.justice.gov/opa/pr/2010/January/10-crm-083.html
This is likely the first of several criminal and civil cases that we will see stemming from this scheme. This case serves as a reminder to health care providers that the Anti-Kickback Statute is a criminal statute and the government will prosecute these cases criminally where the facts support such a case.