Michigan patients' Medicare data shared without their knowledge in fraud scheme, prosecutors say

A Michigan woman who owned a home care agency was convicted by a federal jury on charges relating to a $1.6 million scheme to defraud Medicare. 

Ruby Scott, 55, of Farmington Hills, will be sentenced on Sept. 24 on five counts of health care fraud, conspiracy to defraud the United States and pay illegal health care kickbacks, and four counts of paying illegal health care kickbacks, the U.S. Attorney's Office for the Eastern District of Michigan said Friday. 

The jury verdict came down Thursday in the case involving Scott's activity during 2028 through 2021, while she was the owner of Delta Home Health Care LLC. 

The district attorney's office said that according to court documents and evidence presented in trial, Scott bribed a discharge nurse "at a Detroit hospital" to identify Medicare patients and fax their confidential information to Delta. The two had known each other from a previous business connection. 

The medical information went to Delta without the patients' knowledge. 

The district attorney's office said the kickback relationship with the nurse involved $100 per patient for referrals to her company, along with $300 for each patient that Scott successfully billed to Medicare. 

"Scott paid the discharge nurse over $130,000 by CashApp, PayPal, check, and cash. Scott used these stolen profiles to bill Medicare for home health services, exploiting the diagnostic and personal information of patients who were unaware their data had been compromised," the district attorney's office said. 

During the billings, the district attorney's office said, "Scott falsely represented to Medicare that a doctor had certified patients as meeting the Medicare requirements to receive home health services, including being homebound, when evidence proved no doctor had ever evaluated these patients for home health services." 

Some of the doctors listed were real people, "when, in reality, these doctors had never even met the patients and did not know that Scott was using their information to fraudulently bill Medicare." 

Furthermore, the prosecutors said Delta failed to maintain patient files for over one-third of the patients whose claims it submitted to Medicare. 

Such losses, according to a court witness, "could make it difficult for Medicare to pay on claims that are true and accurate." 

The Federal Bureau of Investigation, Detroit Field Office, and the Department of Health and Human Services, Office of Inspector General, investigated the case.