Medicare Kickback Scheme Gets Woman Four Year Sentence

A $2 million scheme to defraud the federal government got a Louisiana woman 51 months in prison for orchestrating kickbacks for placements of mentally ill patients.

Federal prosecutors alleged Kim Ricard and her partner, Milton Diaz, conspired to defraud the government using a Medicare kickback scheme where Ricard and Diaz would pay home healthcare agencies to take patients causing $2 million in fraudulent billings. Ricard made $330,000 from the Medicare kickback scheme, accused prosecutors.

Ricard is accused of transferring mentally ill patients to the highest bidding home healthcare agencies. Because of her position, alleged prosecutors, she could move patients wherever she wanted and did so, regardless of the needs of the patient. Prosecutors say that the Medicare kickback scheme involved nursing homes in four states.

“As time went on, defendant Kim Ricard demanded to be paid more money and to be paid more frequently … The evidence will show that when defendant Kim Ricard wasn’t paid what she demanded, she would simply transfer the patients to the highest bidder without regard for patient care,” argued federal prosecutors in court.

Ricard’s defense lawyer argued that she did not know the scheme was wrong. “[Federal prosecutors] can’t prove that my client knew that she did anything wrong in accepting money to refer patients or bring patients to Progressive,” stated the attorney in her opening argument.

Federal prosecutors alleged, however, that Ricard’s personal relationship with the director of a psychiatric care department at a hospital allowed her to control patient care.

Ricard was convicted of one count of conspiracy to pay and receive kickbacks, three counts of receiving kickbacks, three counts of identity theft, and one count of making false statements to federal agents.

Her partner will be sentenced in April of this year. Federal prosecutors allege that he caused nearly $2 million in fraudulent Medicare billings to the federal government as a part of the illegal referrals related to the Medicare kickback scheme.

Medicare Kickbacks and Fraud

Illegal Medicare kickbacks and other fraud steal much needed money from federal programs for the poor and elderly and ultimately cost U.S. taxpayers. In addition to illegal kickbacks for referrals, Medicare fraud includes submitting false bills and overbilling.

The federal government has ramped-up efforts to combat Medicare and Medicaid fraud, but often it is a courageous whistleblower working for a healthcare organization that initiates prosecution of these illegal activities. Whistleblowers are protected from retaliation and may be entitled to an award under the federal False Claims Act for reporting fraud against the government.

Awards under the False Claims Act for successful litigation or settlement can be substantial – verdicts and settlement agreements can run into the millions for Medicare and Medicaid fraud and whistleblowers can receive 15 to 30 percent of that amount.

The Medicare Kickback Scheme Lawsuit is U.S. v. Diaz, et al., Case No. 2:15-cr-00232, in the U.S. District Court for the Eastern District of Louisiana.

If you are concerned about kickbacks or other illegal activity at your place of employment, contact the attorneys at Bradley/Grombacher to help evaluate your claim.

Note: Bradley/Grombacher is not representing the plaintiff in this lawsuit.