Hemochromatosis is a disorder in which the body builds up too much iron. It can affect the skin, heart, liver, pancreas, pituitary gland and even joints. When there is too much iron in the body, it is toxic. High toxicity can lead to damaged tissues and organs.
Polycythemia is a condition defined by having an abnormally high number of red blood cells. It often impacts those with lung or heart disease and/or people who live at high altitudes. Symptoms include dizziness, fatigue, shortness of breath, headaches, itchiness and skin discoloration.
Phlebotomy is a procedure that treats people who have hemochromatosis and polycythemia.
It is the process of removing blood from the body. Doing so regularly decreases iron levels in the body as it reduces the number of iron-rich red blood cells. Generally a half-hour in length, the procedure involves a health professional inserting a needle into the vein of an arm to remove about 17 fluid ounces of blood. Patients who undergo the phlebotomy procedure generally sit or lie down.
Needless to say, a phlebotomy is a pretty important treatment for people with high iron levels. In the state of California, 59 year-old Gabriella Santibanez and her 55 year-old sister, Lisa Hazard owned a mobile phlebotomy company known as PhlebXpress Inc. It provided phlebotomy and other medical collection services at patients’ homes and long-term care facilities in and around the Sacramento area.
Both sisters have received 15-month prison sentences.
As reported by the Eastern District of California branch of the U.S. Attorney's Office yesterday, Santibanez and Hazard were sentenced to 15 months in prison for committing health care fraud. They were also ordered to pay over $7.5 million in restitution. Court documents showed that between December of 2015 and December of 2020, the sisters agreed to bill Medicare for services provided that were not reimbursable by Medicare.
“Santibanez and Hazard also agreed to bill Medicare for overstated mileage that PhlebXpress phlebotomists traveled,” the report details, “On average, Santibanez and Hazard caused false billing to Medicare of over 140 miles for each patient seen by PhlebXpress. Santibanez and Hazard caused a loss to Medicare of at least $7.5 million based on false billing by PhlebXpress.”
Medicare instituted a payment suspension for PhlebXpress.
In November of 2020, Medicare ceased paying PhlebXpress for the services it continued to bill the insurance program. This was due to “credible allegations of fraud” at PhlebXpress. Court documents also showed that between July 1 and December 31 of 2021, Santibanez and Hazard worked to avoid the payment suspension. They claimed to Medicare that services were provided to Medicare patients by another company, known as Phlebotomy Solutions.
In truth, the services were indeed provided by PhlebXpress through its contractors and employees from PhlebXpress’ offices. Not only did the sisters use Phlebotomy Solutions to bill Medicare for a non-reimbursable service, they also misrepresented the mileage traveled by phlebotomists. This was done to increase the amount of money for Medicare to pay out. In total, Santibanez and Hazard caused a loss to Medicare of at least $50,000 based on false billing by Phlebotomy Solutions.
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