RGV home health company owner sentenced to prison for fraud

The owner of a Rio Grande Valley area home health company, Sambritt Home Health LLC, was sentenced to prison Thursday after he was convicted of conspiracy to commit healthcare fraud, according to a news release from the U.S. Attorney’s Office.

Miguel Angel Contreras, 44, pleaded guilty on April 14, 2016.

U.S. District Judge Micaela Alvarez sentenced Contreras to nearly four years in prison followed by one year of supervised release. In addition, Alvarez ordered Contreras to pay over $1 million in restitution.

During sentencing, Alvarez noted the duration of the fraud and the multiple ways in which it was committed.

Contreras admitted to submitting false and fraudulent claims to Medicare for reimbursement of home health services that were never provided, that a physician hadn’t authorized and/or were not medically necessary.

“The false and fraudulent claims Contreras submitted to Medicare totaled $724,056.02,” the news release said. “As a result of the false and fraudulent claims, Medicare paid approximately $1,037,353.78.”

He also admitted to forging and/or causing others to forge the signatures of physicians on the referral forms or 485 forms knowing that the physicians didn’t authorize the need for home health services.

“Contreras directed employees to create ‘ghost notes’ for patient files which were intended and calculated to make the fraudulent claims submitted to Medicare appear legitimate,” the release said.

Furthermore, Contreras admitted he directed employees and/or co-conspirators to bill Medicare for home health services with 485 forms, which were missing physician signatures.

Contreras was allowed to remain out on bond and voluntarily surrender to a U.S. Bureau of Prisons facility, which will be determined in the near future.