As we look back on an incredibly tumultuous year in healthcare, let’s explore some of the most significant healthcare fraud cases in 2020. While much of the year has focused on COVID-19, the number of fraud cases relating to opioid prescription abuse, Medicaid and Medicare claim abuses, and illegal drug distribution continued to trend. In this post, we discuss some of 2020’s notable healthcare fraud cases from the OIG and DOJ.
Atlanta-based home healthcare provider defrauds Medicaid out of $1 million
Sentenced for defrauding Medicaid out of nearly $1 million. Diandra Bankhead, the owner, and operator of Elite, submitted thousands of fraudulent claims for services that were never provided to medically fragile children under the Georgia Pediatric Program. Elite Homecare submitted more than 5,400 claims to Georgia Medicaid between September 2015 and April 2018—the vast majority of which were fraudulent—and for which Elite received $1.2 million in reimbursement.
Bankhead submitted fraudulent claims for in-home nursing services allegedly provided to families who had not retained Elite to provide any services, in the names of multiple individuals, including RNs, who did not provide the services in question and did know that their identities and credentials were being used.
On December 2, 2020, in Atlanta, Georgia, Bankhead was sentenced to five years and three months in federal prison, and three years of supervised release, and ordered to pay $999,999 in restitution.