Veasey and Eleda were prime-time players in an elephantine $375-million plot that cranked out thousands of false claims for phony care of supposedly infirm and homebound seniors. The pair shines a cold light on how a Dallas-area doctor named Jacques Roy masterminded the home-healthcare ripoff.
Medicare gives seniors a leg up if they’re stuck in their homes, too unhealthy to get around. Uncle Sam pays for specialists to come to their homes and help with their day-to-day medical needs.
Phony home-health claims have robbed Medicare for years. What’s new was Roy’s dark genius for amping up patient recruiting and fake claims to unheard-of levels of industrial efficiency. One more reason Medicare thievery of all kinds could be America’s single largest form of insurance fraud.
Claimed 11,000 seniors in his care
Roy specialized in certifying people for home healthcare benefits, taking this con to new heights. He created a fantasy world, falsely certifying 11,000 seniors as eligible for home healthcare. He convinced Medicare that somehow these seniors were all under his close medical care and supervision.
Veasey and Eleda ran home-health agencies in the Dallas area. They helped Roy convince Medicare that often-homeless street people were eligible for home-health visits. Or that perfectly healthy, mobile seniors were bedridden and needed homecare.
Roy bribed 500 home-health agencies like Veasey’s and Eleda’s to pump him with patients. The gang paid many beneficiaries cash, food stamps and groceries to hand over their Medicare identifiers. The seniors’ personal information such as SSN was rocket fuel for his con.
Roy falsely certified the seniors for homecare. He received a slice of fake claims the home agencies billed, and soaked Medicare for his own home visits as the supervising doctor. Roy even set up a boiler room where employees worked all day robo-signing his name on Medicare claims.
Veasey knocked on doors, convincing healthy seniors to hand over their Medicare and other personal information for Roy. Veasey was a large and reliable source of patients, feeding Roy their names and personal information for false billing.
Eleda pulled in homeless seniors off the streets, for example. She often bribed cohorts $50 per beneficiary they found and sent to her vehicle parked outside a Dallas homeless shelter’s gates. She promised the homeless people free McDonald’s meals for their medical information.
Forged patient care plans
Eleda also invented medical records to make it seem the seniors qualified for home healthcare. And she forged patient care plans, and helped dummy up daily logs supposedly documenting hundreds of worthless or phantom patient-care visits.
This frenetic activity let Roy and the collaborating home-health agencies pour bills into Medicare under the happy illusion of homebound seniors getting care they needed, under the watchful eye of a physician.
Roy was bound to attract attention. On paper, he ran the largest home-health operation in the U.S. — dozens of times more than any specialist practitioner.
Medicare got wind and started investigating. Investigators found healthy seniors mowing their lawns and working on cars in their driveways. Veasey was handed 14 years in federal prison, and Eleda four years. Roy will face up to life in federal prison when sentenced.
The welcome mat for Roy’s uncaring homecare plot was yanked, replaced with a lock and key that will keep the conspirators, well, homebound in jail for years to come.