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Medicare fraud convictions overturned

Sometimes things are not what they appear to be. Nevertheless, our legal system so often finds a way to deliver justice, even after someone has been accused and convicted of crimes. That is the case with a doctor and owner of a home health care business.

The two were convicted last year of health care fraud and conspiracy to commit health care fraud. Citing a lack of evidence of guilt, a federal appeals court recently overturned those convictions, however.

The physician had been accused of making fraudulent referrals for home health care. She was medical director of Christian Home Health Care, a company owned by her co-defendant. The firm billed Medicare for $28.2 million between 2007 and 2015.

The appeals court said that government witnesses had failed to implicate the doctor or the company owner. The court went so far as to state that the government’s reliance on the witnesses was “peculiar.”

According to a news report, the judges wrote: “Unlike other salient cases involving conspiracy to commit health care fraud, here the government presented 18 witnesses, none of whom could provide direct evidence of their alleged co-conspirators’ actions because the witnesses never acted with the defendants.”

The government’s case was circumstantial, including an allegation that the doctor began making more referrals to the company owned by her co-defendant after she became medical director. The judges noted that it wasn’t surprising — or criminal — for the doctor to increase in referrals to the company she worked for.

The doctor had been sentenced to six years in prison and was incarcerated in Alabama. The home health company owner had been sentenced to eight years and was incarcerated in Florida.

Skilled attorneys make an important difference in people’s lives. We hope these two women unfairly accused and convicted can quickly rebuild their lives.