A federal jury in the Eastern District of Michigan convicted a Michigan nurse and home health care agency owner yesterday for operating a $1.6 million scheme to defraud Medicare. According to court documents and evidence presented at trial, Ruby Scott, 55, of Farmington Hills, Michigan, owned and operated Delta Home Health Care LLC (Delta). From 2018 through 2021, Scott bribed a discharge nurse at a Detroit hospital to identify Medicare patients and fax their confidential records to Delta, unbeknownst to the patients.
Key details of the case
Scott had developed the kickback relationship with the hospital discharge nurse at a home health company she had previously co-owned. She offered the nurse an additional $100 patient to induce her to refer patients to her new company. 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 evidence at trial showed that Scott paid the discharge nurse approximately $300 for each patient Scott successfully billed to Medicare. In billing claims for patients who were obtained through kickbacks, as well as other claims between 2018 and 2024, 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.
Meanwhile, in many instances, Scott used the identities of real doctors to fabricate the existence of these evaluations 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. A witness testified one patient for whom Delta received thousands of dollars in payments had never received services from Scott’s company. Delta failed to maintain patient files for over one-third of the patients for which it submitted claims to Medicare, for whom Medicare paid Delta over $1.2 million.
Enforcement actions and official statements
Scott caused approximately $1.6 million in losses to Medicare. A witness testified drains the Medicare trust fund and could make it difficult for Medicare to pay on claims that are true and accurate. The jury convicted Scott of five counts of health care fraud, conspiracy to defraud the United States and pay illegal health care kickbacks.
As a result, four counts of paying illegal health care kickbacks. She is scheduled to be sentenced on Sept. 24 and faces a maximum penalty of 10 years in prison as to each health care fraud count, a maximum penalty of 10 years in prison as to each kickback count. A maximum penalty of five years in prison as to the conspiracy count. For complete details, refer to the official DOJ press release.
Consequently, a federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors. Assistant Attorney General Colin M.
McDonald of the Justice Department’s National Fraud Enforcement Division. Special Agent in Charge Reuben Coleman of the FBI Detroit Field Office; and Special Agent in Charge Thomas Ethridge of the Department of Health and Human Services Office of Inspector General (HHS-OIG) made the announcement. The FBI Detroit Field Office and HHS-OIG investigated the case. For related coverage, see Trafficking indictment accuses alleged CJNG leader of cocaine, heroin, and methamphetamine distribution.
Specifically, trial Attorneys Kelly M. Warner and Ahmad Huda of the Criminal Division’s Fraud Section are prosecuting the case. On April 7, the Department of Justice announced the creation of the National Fraud Enforcement Division (“Fraud Division”).
Subsequently, the Fraud Division is laser-focused on investigating and prosecuting those who commit fraud against the American people. The Department’s work to combat fraud supports President Trump’s Task Force to Eliminate Fraud, a whole-of-government effort chaired by Vice President J.D. Vance to eliminate fraud, waste. For related coverage, see Owner of health care software company convicted of 1 billion dollar medicare fraud conspiracy — DOJ.
Abuse within Federal benefit programs.The Department of Justice’s Health Care Fraud Strike Force Program, currently comprised of nine strike forces operating in federal districts across the country, has charged more than 6,200 defendants who collectively billed federal health care programs and private insurers more than $45 billion since 2007. In addition, the Centers for Medicare & Medicaid Services, working in conjunction with the Office of the Inspector General for the Department of Health and Human Services, are taking steps to hold providers accountable for their involvement in health care fraud schemes. More information can be found at www.justice.gov/criminal-fraud/health-care-fraud-unit.