“Skid Row” Health Care Fraud: Doctor Guilty for Recruiting Homeless to Defraud Medicare and Medi-Cal

“Skid Row” Health Care Fraud: Doctor Guilty for Recruiting Homeless to Defraud Medicare and Medi-Cal

 In the first case filed in relation to the second major investigation into the illegal recruitment of “Skid Row” homeless people in Los Angeles for unnecessary medical procedures, a La Mirada, California, doctor has pleaded guilty to federal tax charges and admitted participating in a large-scale scheme to defraud Medicare and Medi-Cal.

Dr. Ovid Mercene pleaded guilty to subscribing to a false tax return.

From 2008 and 2012, while Mercene worked at a Los Angeles-area hospital, he admitted patients, the vast majority of whom were homeless, who had been referred from a purported “care consortium.” The patients, many of whom did not require hospitalization, were admitted for the purpose of defrauding taxpayer-funded health programs such as Medicare, Mercene admitted in court.

Mercene admitted the “patients” after watching them being transported by van from Skid Row to the hospital, where they were often kept on a special floor away from the hospital’s “regular” patients, prosecutors said. These “patients” also were given smoking breaks while in the hospital, even though many of them supposedly suffered from respiratory diseases. After a short hospital stay where numerous unnecessary tests were typically performed, Mercene discharged the “patients” to skilled nursing facilities, even though they did not require such care, according to the government.

Mercene billed Medicare and Medi-Cal more than $1.8 million for medically unnecessary services provided to the Skid Row patients while in the hospital or at a skilled nursing facility.

Prosecutors said that Mercene received nearly $700,000 in cash kickbacks for admitting “patients” to skilled nursing facilities – income he did not report on his tax returns.

The case against Mercene is part of an ongoing investigation into the recruitment of Skid Row patients being conducted by the U.S. Department of Health and Human Services, Office of Inspector General; the Federal Bureau of Investigation; IRS-Criminal Investigation; and the California Department of Justice’s Bureau of Medi-Cal Fraud and Elder Abuse.

 Contact the author at smeyerow@optonline.net

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