Artful Dodge: Medicare Fraud Case Closed

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Philadelphia – Irina Segal, owner of Bucks County’s Segal Arts, LLC, just cut a deal with federal prosecutors, agreeing to shell out $200,000 to settle allegations of Medicare fraud. The feds say Segal’s company billed the government for one-on-one occupational therapy that never happened.

Instead of providing the medically necessary, skilled therapy Medicare paid for, Segal Arts ran group arts-and-crafts sessions at assisted living facilities in Pennsylvania and New Jersey, according to a complaint unsealed today. Investigators with the Department of Health and Human Services’ Office of Inspector General (HHS-OIG) reportedly sat down with Segal and explained the rules – one-on-one, *skilled* therapy for specific billing codes. Segal allegedly didn’t change her practices and didn’t refund the money.

U.S. Attorney David Metcalf stated the case highlights their commitment to pursuing those who rip off Medicare, particularly when it impacts care for the elderly. Maureen Dixon, Special Agent in Charge with HHS-OIG, emphasized the agreement demonstrates a dedication to ensuring Medicare dollars go to actual patient care. The $200,000 payment is based on Segal’s ability to pay.