Poliakoff & Associates, P.A. Advocacy, Medicare No Comments

Health Care Fraud

A grand jury indicted Kevin Breslin and KBWB Operations, LLC, doing business as Atrium Health and Senior Living (Atrium) with a scheme to defraud Medicare and Medicaid. The indictment alleges that the scheme operated from January 2015 to September 2018. The indictment charges the defendants with health care fraud, wire fraud, mail fraud, tax fraud, and money laundering.

According to the indictment, Breslin was the Chief Executive Officer of Atrium, which operated 24 skilled nursing facilities and nine assisted living facilities in Wisconsin and Michigan.

Atrium billed Medicare for over $189,000,000 and received over $49,000,000. They billed Medicaid for over $218,000,000 and received over $93,000,000. Evidence shows the defendants obtained money from Medicare and Medicaid. They agreed to follow all required quality of care standards. They failed. Atrium agreed to operate their facilities with adequate staffing, supplies, and services, but they did not do so.

Diversion of Funds

The indictment alleges that as part of the scheme to defraud, Breslin and Atrium diverted funds from the facilities through payments to Atrium owners. They also guaranteed monthly return-on-investment payments to investors. The insufficient funds caused inadequate care of residents, including a shortage of diapers, wound care supplies, and a lack of durable medical equipment.

In addition, the diversion of funds caused non-payment to vendors. This caused services to be cut off, including physical therapy and necessary repairs and maintenance of the physical plant facilities.

An indictment is an allegation. All defendants are innocent until proven guilty beyond a reasonable doubt in a court of law.