We are seeing an increased focus on nonprofit health care entities that are run by individuals. One recent case shows how nonprofits can face scrutiny that includes conflict of interest issues and concern over whether payments to executives or employees.On August 13, 2018, Sandra Haar pleaded guilty to health care fraud and conspiracy to receive kickbacks in federal court in Fresno.
Ms. Haar was the founder and chief executive officer of Horisons Unlimited, a nonprofit public benefit corporation that provided health and dental services in Merced and surrounding communities. Ms. Haar was also a nurse practitioner. Horisons is now closed but once had eight clinics.
According to court documents, between January 1, 2014, and March 2017, Ms. Haar allegedly orchestrated the billing to Medicare and Medi-Cal for services she knew were not reimbursable, and she allegedly profited by over $3.7 million from her fraud. For example, Ms. Haar allegedly billed Medi Cal for health and dental services that were not rendered and for unnecessary health care services.
One of the more outrageous allegations was that Ms. Haar billed Medi-Cal for office visits with purportedly licensed doctors when the patients instead were dispensed Suboxone, an opioid medication, in the parking lots of McDonald’s and Rite Aid in baggies.
According to the plea agreement, Ms. Haar also received thousands of dollars in kickbacks in cash from an account executive at a laboratory in exchange for using it for Horisons patients’ laboratory testing.
This case is the product of a joint state and federal investigation by the Federal Bureau of Investigation, the U.S. Department of Health and Human Services Office of Inspector General (HHS OIG), the California Department of Health Care Services, and the California Bureau of Medi-Cal Fraud & Elder Abuse.
Ms. Haar is scheduled to be sentenced by U.S. District Judge Lawrence J. O’Neill on January 28, 2019. The actual sentence will be determined at the discretion of the court after consideration of any applicable statutory factors and the Federal Sentencing Guidelines, which take into account a number of variables.
Posted by Tracy Green, Esq.
Green and Associates, Attorneys at Law
