Operator of Residential Nursing Facility Sentenced for Health Care Fraud

 NORFOLK, Va. – A Portsmouth man was sentenced today to two years in prison for defrauding the Virginia Medicaid program by submitting over $188,000 in false claims for a residential nursing facility.

“For three years, the defendant used his position as a nursing home operator to fraudulently obtain over $188,000 from the Virginia Medicaid program,” said Raj Parekh, Acting U.S. Attorney for the Eastern District of Virginia. “Health care fraud takes funding and critical services away from those who truly need it. We will continue to hold accountable those who exploit these essential health care programs at the expense of vulnerable members of our communities.”

According to court documents, Lopez Scott, 47, operated Turning Points Residential Care, a business authorized to provide residential support services and skilled nursing services to recipients of Medicaid. Between October 2016 and October 2019, Scott submitted numerous false and fraudulent claims to Virginia Medicaid, known as the Virginia Medical Assistance Program (VMAP), which misrepresented that 5,847.75 hours of skilled nursing services had been provided to a Medicaid recipient. As a result, Scott received approximately $188,297.39 in health care payments to which he was not entitled.

“When Lopez Scott launched his fraud scheme, he threatened the integrity of the Medicaid program and illegally pocketed taxpayer funds meant to pay for the legitimate care of needy patients,” said Special Agent in Charge Maureen R. Dixon of the U.S. Department of Health and Human Services (HHS) Office of the Inspector General. “Along with our law enforcement partners, we will continue to hold such fraudsters accountable for their unprincipled actions.”

According to court documents, in order to conceal and cover up the fact that no skilled nursing services had been provided to the Medicaid recipient, Scott created fraudulent entries of nursing notes in the electronic office records of Turning Points, including the forged signature of a nurse, which falsely indicated that such services had been provided. Scott also asked this nurse to falsely state to investigators that she had continued to work for the company even after her employment had ceased.

Raj Parekh, Acting U.S. Attorney for the Eastern District of Virginia, and Maureen R. Dixon, Special Agent in Charge of the Office of Inspector General for HHS, made the announcement after sentencing by U.S. District Judge Robert G. Doumar.

Assistant U.S. Attorney Alan Salsbury prosecuted the case.