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$3.1 million judgment entered in Medicare fraud case

$3.1 million judgment entered in Medicare fraud case

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SIOUX CITY -- A federal judge has entered a $3.1 million judgment against five home health care facilities, including units in Sergeant Bluff and Elk Point, South Dakota, accused of filing fraudulent Medicare claims.

A federal complaint filed in U.S. District Court in Sioux City alleged that Sergeant Bluff Healthcare and Elk Point Healthcare filed Medicare claims from January 2012 through December 2015 for home health services billed by a third-party provider for services that did not qualify for Medicare coverage and were not justified or necessary considering the patients' medical conditions.

For most of that time, the facilities were managed by a Minnesota company that has since gone out of business.

Chief U.S. District Judge Leonard Strand on Wednesday entered a consent judgment of more than $1.245 million against Sergeant Bluff Healthcare, which operated Embassy Healthcare Community, and $788,484 against Elk Point Healthcare #1, which operated Prairie Estates Healthcare Community. The facilities had been managed by Welcov Entities, of Edina, Minnesota, until 2018, when management was turned over to a South Dakota company.

[Read more: Sioux City plastic surgeon accused of filing $64,000 in fraudulent claims in Michigan.]

The facilities now operate as WEL-Home Health and Embassy Rehab & Care Center in Sergeant Bluff and WEL-Home Health and Prairie Estates Care Center in Elk Point.

Facilities in Red Oak, Iowa, Logan, Iowa, and Flandreau, South Dakota, also were listed in the complaint and judgment order.

Welcov has filed for assignment for benefit of creditors, an action similar to bankruptcy, in a Minnesota court and assigned its assets to an assignee to be held until an agreement can be reached for payment of its creditors. The federal judgment filed Wednesday will be one of the many claims that have been filed against Welcov. The assignee is in the midst of reconciling those claims.

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