Owner of Waltham Nursing Agency Gets Jail, Loses Home, for Medicare Scheme

A Natick man who owns a nursing home agency was sentenced to 92 months in prison, fined and will lose his home for fraudulently billing millions of dollars of services to Medicare and then laundering the proceeds.

Michael Galatis, 63, was sentenced by U.S. District Court Judge Douglas P. Woodlock, who also sentenced him to three years of supervised release. Galatis was ordered to pay a $50,000 fine, $7 million in restitution to Medicare, and forced to forfeit proceeds of the fraud scheme, including his house, valued at $850,000.

According to the press release from United States Attorney Carmen M. Ortiz, Galatis’s trial, which lasted 16 days, began in December, 2014 and he was tried for conspiracy to commit health care fraud, ten counts of health care fraud, and seven counts of money laundering.

A registered nurse, he owned and operated At Home VNA, a home health agency located in Waltham. From 2006 to 2012, Galatis submitted more than $27 million in false and fraudulent home health care claims to Medicare. Medicare paid AHVNA more than $20 million of those fraudulent claims.

The Medicare program pays for home health services only if the services are medically necessary and the individual is homebound. Galatis ignored these requirements and trained AHVNA nurses to recruit healthy individuals with Medicare insurance who lived in large apartment buildings, according to the release.

Galatis would hold what he called “wellness clinics” at buildings and nurses convinced seniors to enroll with AHVNA, having the nurses visit them at their homes. Galatis and his co-conspirator trained AHVNA nurses to manipulate the patients’ Medicare assessment forms to make it appear as though the patients qualified for Medicare home health services, when that was often not the case, said the release. Galatis paid a physician, Dr. Spencer Wilking, to sign the home health care orders, even though Dr. Wilking did not examine the vast majority of AHVNA’s patients.

Evidence showed that the patients’ primary care physicians had not referred the patients to AHVNA, and were also unaware that AHVNA was sending nurses to their patients. Physicians complained to Galatis and told him that the patients didn’t didn’t need the nurses, but the complaints were ignored. Also in the testimony, AHVNA nurses said that they told Galatis that the patients didn’t need to be visited, but Galatis refused to discharge them.

Medicare passed a requirement in 2011 that said that a physician must certify that she or he had a face-to-face visit with a patient about his or her needs for home health care. Galatis billed Medicare for millions of dollars in home health care even after this regulation was enacted, said the release. Dr. Wilking also signed the orders without examining the patients.

Galatis bought a house valued at $850,000 in Natick with the fraud proceeds.

Registered nurse Janice Troisi, the AHVNA clinical director, goes to trip on July 27. Dr. Wilking pleaded guilty in February 2014 to health care fraud. His sentencing is Sept. 22.