Couple Who Stole Parkland and Baylor Hospital Patient Names to Bill Medicare Get Federal Prison Time

The former Parkland Memorial Hospital patients were approved for home health care services paid by Medicare even though some were spotted mowing their lawns and driving, federal prosecutors said.Dallas Home Health Care owner Viju Mathew gave them grocery gift cards and cash to remain as clients even though they weren't homebound and in need of such services, said Assistant U.S. Attorney Doug Brasher. The company also had a successful marketing ploy: sign up if you need a free housekeeper, he said.On Monday, Mathew and his wife, Mariamma Viju, were both sentenced to 30 months in federal prison for the scheme. The Garland couple drummed up business for their company, Dallas Home Health Care, by stealing patient lists from Parkland and Baylor University Medical Center in Dallas where they worked, Brasher said.Mathew, 52, pleaded guilty in 2014 to a federal fraud charge related to identity theft for stealing confidential patient names from Parkland where he worked as a patient registration specialist.Mathew formed the health care company in 2006, court records say. He had his employees cold-call seniors for services they didn't need or qualify for, court records said. He then billed Medicaid and Medicare for the services, which often consisted of filling pill boxes, according to court records. Authorities say he accessed the private information of more than 3,000 patients by computer. Parkland discovered the thefts and fired him in October 2011. Viju, 52, pleaded guilty last year to the wrongful disclosure of individually identifiable health information. She was part owner of Dallas Home Health Care and a registered nurse who worked at Baylor hospital beginning in 2001. She also took patient information from her hospital to solicit business, federal authorities allege.And Viju falsified notes and diagnoses to keep the patients as clients, Brasher said. Baylor fired her in October 2012.U.S. District Judge Jane Boyle told the couple they are both responsible for paying more than $277,900 in restitution to Medicare.Home health care serves an important role in caring for seniors and the disabled who are discharged from hospitals. Many recuperate at home and need care delivered there by physicians, nurses or therapists. Each visit to the patient is billed as an episode of care. But fraud connected with such services has been a big problem in North Texas. A case involving what is believed to be the nation's largest home health care fraud involving a single doctor occurred in the Dallas area.In that case, former Rockwall doctor Jacques Roy was convicted last year of wooing about 11,000 Medicare patients with promises of cash, food stamps and groceries as part of a nearly $400 million home health care scam. Authorities said that Roy and his associates recruited fake patients - including some of Dallas' homeless - to submit the bogus health care claims.Roy, who is scheduled to be sentenced next week, signed forms allowing patients to receive services from Dallas Home Health Care, for which the company was paid more than $126,440, the U.S. attorney's office said.  Continue reading...

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