PA Firm Bilks Medicare Out of $200K

PHILADELPHIA – Bucks County’s Segal Arts, LLC, and owner Irina Segal avoided criminal charges, but will repay $200,000 to Medicare after a federal investigation revealed a scheme to inflate bills. The company allegedly billed the program for one-on-one occupational therapy that never happened, instead offering group art sessions at nursing homes in Pennsylvania and New Jersey.

Federal investigators with the HHS Office of Inspector General directly warned Segal that her billing codes demanded individualized care. She knowingly continued to submit claims for group sessions, a blatant attempt to pocket Medicare funds. The consent judgment filed in the Eastern District of Pennsylvania sets a repayment plan based on Segal’s financial capabilities.

The case highlights a federal crackdown on healthcare fraud. U.S. Attorney David Metcalf stated his office remains focused on prosecuting those who exploit Medicare, particularly when targeting vulnerable seniors. While not a conviction, the settlement sends a clear message: falsifying claims will draw scrutiny.

This isn’t the first instance of providers attempting to game the system. The Department of Justice continues to investigate similar cases across the country, aiming to protect federal healthcare programs from abuse.

Source: U.S. Department of Justice