Doctors Convicted in Fraud Scheme for Unnecessary Hospice-Related Services

Two doctors have been found guilty of falsely certifying Medicare patients were terminally ill and qualified for hospice care. However, the vast majority of the patients actually were not dying.

Two doctors have been found guilty of falsely certifying Medicare patients were terminally ill and qualified for hospice care. However, the vast majority of the patients actually were not dying.

Sri Wijegoonaratna, MD, and Boyao Huang, MD, participated in a scheme related to California Hospice Care (CHC), which submitted $8.8 million in fraudulent bills for hospice-related services between March 2009 and June 2013, according to the Department of Justice US Attorney’s Office in the Central District of California.

“A number of patients admitted to California Hospice Care testified at trial, showing that they did not require end-of-life care,” United States Attorney Eileen M. Decker, said in a statement. “In fact, only a small percentage of patients later died — notwithstanding the two doctors declaring that they needed hospice care.”

Dr Wijegoonaratna was found guilty on 7 counts of healthcare fraud, while Dr Huang was found guilty of 4 counts. They are scheduled to be sentenced on August 15 and face a maximum sentence of 10 years in federal prison for each count. There were 4 other defendants named in a federal grand jury indictment in September 2014. They pled guilty and their sentences are pending.

As part of the scheme, Priscilla Villabroza, who operated CHC, and her daughter paid patient recruiters to bring in Medicare and Medi-Cal beneficiaries. Drs Wijegoonaratna and Huang would then certify the beneficiaries were terminally ill and CHC would alter medical records to make the beneficiaries appear sicker.

“This scheme is one of many that has victimized public health care programs and, in the end, the taxpayers who fund these important programs. We will continue to investigate these fraudulent schemes, shut down the operations and incarcerate those responsible for stealing from the system,” Decker said.

Dr Wijegoonaratna also recruited patients into the fraud scheme and received tens of thousands of dollars in illegal kickbacks. The scheme was eventually shut down in June 2013, but Medicare and Medi-Cal had paid nearly $7.4 million to CHC for medically unnecessary hospice-related services, according to the attorney’s office.