Safety Questions at Clinics Tied to Medicare Fraud

March 28, 2012

Eleven Dallas-area health clinics either face state sanctions or already have closed due to safety failures uncovered during an investigation into a massive Medicare fraud scheme.

The Dallas Morning News reported the issues Saturday after obtaining records from the Texas Department of Aging and Disability Services, or DADS. The safety problems were found at home health care agencies whose Medicare payments were suspended after the Feb. 28 arrest of Jacques Roy, a doctor arrested on allegations that he ran a $375 million Medicare fraud scheme from his office in DeSoto, Texas.

The problems described in the records include a lack of qualified caregivers, nurses failing to assess patients or properly describe their needs to doctors, nurses failing to ensure doctors’ orders were followed and a failure to report exploitation. Names of patients or caregivers are not in the records. The owner of at least one of the agencies was sentenced to prison last year for Medicare fraud. The owners of a third was arrested along with Roy, and also charged with fraud.

The U.S. Government Accountability Office released a study last year that said Dallas had a high number of cases in which home health agencies extended patients’ treatment, a flag for possible fraud.

Most of the problems recorded in the state documents were at T&T Home Health Agency, a clinic that lists an address in a northwest Dallas office building. In March 2010, inspectors found 25 violations of state or federal patient care standards. The records also indicate workers at the agency made “false statements” to the state surveyors. At the same time, federal health officials approved the company for Medicare reimbursements.

In June 2010, DADS moved to revoke the agency’s license, said Allison Lowery, a spokeswoman for the state department. The hearing is scheduled for June.

“While we understand that these agencies are entitled to due process, the T&T situation highlights the need for an expedited resolution in certain cases,” Lowery said. “We’ll continue to hold these agencies accountable for any failures in their operations.”

The Dallas Morning News reported a T&T employee did not respond to phone messages seeking comment.

Two of the closed agencies, De-Promise Home Health Services and Climax Healthcare, were run by a Florence Onyegbu, who was sentenced to four years in prison last year for Medicare fraud. Prosecutors said she fled the country before she was to turn herself in to begin her serving her sentence.

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