New Jersey Home Health Provider Is Sentenced To Two Years For Medicare Fraud
By: Christopher A. Iacono
The former owner of a Hammonton, New Jersey, company that provided home-based physician services to senior citizens was sentenced to two years in prison for overbilling Medicare for patient visits, which led to $511,000 in illegal profits. Lori Reaves, a 52-year-old geriatric physician, pleaded guilty previously to one count of health care fraud before United States District Court Judge Freda L. Wolfson in Trenton.
The founder of Visiting Physician Associates of South Jersey, Reaves was the highest-billing home care provider among more than 24,000 doctors in New Jersey between Jan. 1, 2008, through Oct. 14, 2011, according to United States Attorney’s Office. VPA provided visits to home-bound senior citizens across South Jersey, including Cape May, Salem and Burlington counties. The Government claimed that Reaves reported billing-related procedure codes to Medicare that indicated far more face-to-face time than the routine sessions that VPA’s patients actually received, which inflated the payments to VPA. As the person in charge of VPA’s Medicare billings, Reaves submitted numerous claims that would have required her to spend at least 2.5 hours with patients, when she was often with those patients for only 30 to 45 minutes. As part of the Medicare program, providers have to certify that billed services were medically necessary, and that they were actually administered.
Reaves was sentenced to twenty-four months, which was at the lower end of the applicable Sentencing Guideline range, despite the Government requesting a thirty month sentence. According to Reaves’ counsel, the Court recognized that Reaves’ conduct was an aberration in the overall context of her life, and that Reaves has already suffered serious consequences, including the loss of her medical license. Besides forfeiture of $511,068, Judge Wolfson ordered Reaves to pay restitution in that amount and a fine of $5,000. She was also sentenced to three years of supervised release following her prison term.