Kusserow’s Corner: Latest Health Care Solutions Network Sentencing

On July 8, 2013, the Department of Justice (DOJ) announced the latest in a series of prosecutions in connection with $63 million in fraudulent claims to Medicare and Florida Medicaid between 2004 and 2011 by the defunct health provider Health Care Solutions Network, Inc. (HCSN), a partial hospitalization program (PHP) for treatment of severe mental illness. HCSN paid illegal kickbacks to owners and operators of Miami-Dade County assisted living facilities (ALFs) in exchange for patient referral information to be used to submit false and fraudulent claims to Medicare and Medicaid. To date, fifteen defendants have been charged and have pleaded guilty or been convicted by a jury for their roles in the health care fraud scheme.

The latest action involved Wondera Eason, 51, of Miami who was sentenced after conviction at a jury trial to serve 10 years in prison for her central role. In addition, she is to serve three years of supervised release and to pay $14,985,876 in restitution.  She is a certified medical records technician who was employed as the director of medical records at HCSN. She oversaw the alteration, fabrication, and forgery of thousands of documents to support the fraudulent claims submitted to Medicare and Medicaid.  She also directed therapists to fabricate documents, and forged the signatures of therapists and others on documents that she was in charge of maintaining. She provided false and fraudulent documents to Medicare/Medicaid auditors, while certifying the documents were accurate.

After stealing millions from Medicare and Medicaid in Florida, HCSN’s owner, Armando Gonzalez, expanded the scheme to North Carolina, opening a third HCSN location in Hendersonville, N.C. This case is being investigated by the FBI and HHS Office of Inspector General (OIG) and was brought as part of the Medicare Fraud Strike Force.

Richard P. Kusserow served as DHHS Inspector General for 11 years.  He currently is CEO of Strategic Management Services, LLC (SM), a firm that has assisted more than 3,000 organizations and entities with compliance related matters.  The SM sister company, CRC, provides a wide range of compliance tools including sanction-screening.

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Copyright © 2013 Strategic Management Services, LLC.  Published with permission.