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Bankruptcy Fraud Snares Louisiana Home Health Executive

Submitted by ckanon@abi.org on
A West Monroe, La., businessman whose two home health agencies received millions in Medicare overpayments was sentenced this month to 24 months in prison for concealing assets in a bankruptcy filing, The Ouachita Citizen reported. Earlier this year, Jones pleaded guilty to one count of concealment of assets in the U.S. District Court for the Western District of Louisiana, court documents show. In a Dec. 20 judgment, U.S. District Court Judge Elizabeth Foote sentenced Jones to 24 months in prison with credit for time served as well as a fine of $10,100. Jones’ two companies, United Home Care Inc. and Trinity Home Health Care Inc., have been the subject of a probe by the Federal Bureau of Investigation. United Home Care and Trinity Home Health Care shuttered in 2017. Claims of check-kiting and embezzlement first flew in a 2017 lawsuit Jones filed at Fourth Judicial District Court against two of his colleagues: Charlie L. Simpson, of Downsville, who worked as the chief operating officer of United Home Care and Trinity Home Health Care, and Charles R. Gardner, of West Monroe, who worked as chief financial officer at United and Trinity. In the 2017 lawsuit, United Home Care Inc. and others v. Charlie Simpson and others, Jones accused Simpson and Gardner of embezzling money from his home health agencies. Gardner and Simpson responded with a counter lawsuit against Jones, claiming he was using lawsuits to conceal his participation in the embezzlement. Jones’s sentence this month stemmed from an eight-count indictment last fall. In a grand jury indictment on Sept. 13, 2022, Jones was charged with eight counts of concealment of assets, a violation of federal law.
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Session Description
Many bankruptcy professionals are being called upon to help healthcare provider organizations as this industry faces unprecedented business distress. Whatever the professional's role, some basic understanding of healthcare finance can strengthen decision-making and performance.

This session will provide a high-level view of the unique fiscal considerations in the healthcare provider organization, specifically: 1) accounting and financial statements; 2) cashflow including the massive revenue cycle and accounts payable functions; 3) a murkier part of cashflow buried in the various governmental and private payer reimbursement models, and 4) fraud.

Beginning with accounting and financial statements, the mystery of gross revenue, net revenue, and accounts receivable on the income statement will be examined. Even experienced healthcare CFOs can trip up on accounts receivable calculations given the complexities of payer reimbursement models and payment practices, as well as the payer market changes occurring at an ever-faster pace.

Healthcare provider cashflow management consists of voluminous variations and constant change, more so in revenue cycle but also in accounts payable. Years ago, revenue cycle was simply called “billing.” The term revenue cycle more accurately describes the revenue generation process which can involve every function in the healthcare provider organization, from physician and nursing care to lab work and housekeeping.

Third, fundamentals of the most common healthcare reimbursement models will be discussed starting with basic fee-for-service reimbursement and moving through other models to the present attempts at value-based reimbursement. It may be surprising that while the industry grapples with the new value-based models, a sizable part of reimbursement is still fee-for-service.

Finally, there will be brief mention of fraud and embezzlement which can develop in the troubled healthcare provider organization and may be a significant contributor to poor financial performance.
Learning Outcomes
Participants will gain a high-level perspective on the unique fiscal considerations in the healthcare provider organization to inform their work in advising clients in this troubled industry. A solid base of knowledge in healthcare finance will support accurate financial performance projections, prioritization of turnaround strategies, and organization valuations. Given the esoteric complexities in this field, attendees will also gain an appreciation for situations where using healthcare financial specialists may be helpful.

First, participants will understand special aspects of income statements for healthcare provider organizations, in particular the difficulty of estimating accounts receivable due to the variability in the payer market, reimbursement models, and billing policies and procedures.

Second, attendees will be able to discuss the umbrella structure of cashflow in the healthcare provider organization from revenue generation to accounts payable.

They will understand the fundamentals of the “revenue cycle” which spans the entire healthcare provider organization. They will also be able to outline some mid-level billing functions, common operational problems with billing in the distressed healthcare organization, and practical solutions to address them, including artificial intelligence (AI).

On the other side of cashflow management, participants will understand the cash management structure and issues in vendor contracting, purchasing, and accounts payable in the healthcare organization.

Next, participants will gain a deeper awareness of how various healthcare reimbursement models in the marketplace – e.g., Medicare Advantage, health maintenance organizations (HMOs), high-deductible plans, accountable care organizations (ACOs), etc. – affect the financial performance of healthcare provider organizations.

Finally, attendees will be made aware of some places fraud and embezzlement may develop in the distressed healthcare organization.
Target Audience
Creditor
Suggested Speakers
Jeanne
Goche, MA, JD
jgoche@SolutionsinHealthCareManagement.com
Denise
Hill, JD, MPA
denise.hill@drake.edu
First Name
Jeanne
Last Name
Goche, MA, JD
Email
jgoche@SolutionsinHealthCareManagement.com
Firm
Solutions in Health Care Management, a consultancy and financial advisory specializing in health care

Three Arrows Capital Founders Face $1.1 Billion Asset Freeze

Submitted by jhartgen@abi.org on

The founders of a failed crypto hedge fund have been hit with a billion-dollar asset freeze, the Wall Street Journal reported. Su Zhu and Kyle Davies, who ran collapsed crypto hedge fund Three Arrows Capital, have been ordered by a British Virgin Islands court not to sell assets worth $1.144 billion, according to Teneo, the liquidator of the fund. The order also names Kelly Chen, Davies's wife. It is the latest effort by Teneo to seize assets from Zhu and Davies after the failure of Three Arrows, which made the duo deeply controversial figures in crypto. Zhu was held by Singaporean authorities in September, after Teneo won a court order. After two months, he was transferred from prison to home detention to serve the rest of the sentence. He was released earlier this week. Teneo said that the assets it wants frozen are intended to cover fund losses that the founders could have prevented. The freeze prevents Zhu from selling two properties in Singapore, while Davies and Chen can't dispose of one unit in the country, according to court documents. Zhu, Davies and Chen can each spend up to $10,000 a week to cover living expenses, but must let Teneo's lawyers know where the money will come from, the documents say.

SEC Charges Tingo Group Nigerian CEO, Three Companies with Fraud

Submitted by jhartgen@abi.org on

The U.S. Securities and Exchange Commission (SEC) on Monday filed charges against Nigerian businessman Dozy Mmobuosi and three companies of which he is CEO, alleging they inflated the financial performance of the companies and key subsidiaries to defraud investors, Reuters reported. The SEC said in a statement that it filed charges in U.S. District Court in New York against Mmobuosi, who made headlines this year following a bid to buy an English premier league team. The SEC also charged Tingo Group, Agri-Fintech Holdings and Tingo International Holdings for violating the anti-fraud provisions of the federal securities laws and Nasdaq reporting and internal controls. Tingo Group's shares slumped in June after short-seller Hindenburg Research criticized its founder and alleged that the fintech firm had "fabricated" its financials.

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Former Hollywood-Based Anti-Poverty Nonprofit CEO Sentenced to Six Months in Federal Prison for Embezzlement and Cheating on Taxes

Submitted by jhartgen@abi.org on

The former president and CEO of a Los Angeles-based anti-poverty nonprofit agency was sentenced today to six months in federal prison for embezzling money from the nonprofit for his personal benefit, failing to report these funds on his tax returns, and intentionally misapplying more than $600,000 in grant money to pay for unauthorized expenses, according to a DOJ press release. Howard Dixon Slingerland of Studio City, Calif., was sentenced by U.S. District Judge Dolly M. Gee, who also ordered him to serve six months of home confinement, pay a fine of $10,000, pay $750,470 in restitution and to perform 200 hours of community service. Slingerland pleaded guilty on March 8 to one count of conversion and intentional misapplication of funds from an organization receiving federal money and one count of subscribing to a false federal income tax return. From 1996 until he was fired in September 2019, Slingerland led the Youth Policy Institute Inc. (YPI), a Hollywood-based nonprofit agency that worked to eradicate poverty, eventually becoming president and CEO. YPI operated in some of the highest needs neighborhoods in Los Angeles, running programs aimed at supporting youth education, development, safety, job training, and health and wellness. As the head of YPI, Slingerland had check-signing authority over YPI’s bank accounts and was the personal guarantor of YPI’s credit card. From January 2015 to February 2019, Slingerland caused at least $71,533 of YPI funds to be spent on unauthorized expenditures, including Slingerland’s personal property tax bill that exceeded $14,000; a Slingerland family dinner at an upscale New York City restaurant costing more than $6,000; private tutoring for a family member costing nearly $11,000; and a home computer and software valued at nearly $2,000.

Judge Appoints Receiver to Liquidate GPB Capital Holdings

Submitted by jhartgen@abi.org on

Private-equity firm GPB Capital Holdings, facing civil fraud allegations since early 2021, will be liquidated by a court-appointed receiver, signaling the end of a long wait for roughly 17,000 investors whose capital has been tied up since at least 2018, the Wall Street Journal reported. Chief Judge Margo Brodie of the U.S. District Court for the Eastern District of New York put GPB under the control of Joseph Gardemal of Alvarez & Marsal, the firm’s court-appointed monitor since February 2021. As its monitor, Gardemal could veto moves by firm managers but had limited power to do more, and for more than a year he has recommended receivership to expedite the return of investor capital. “We are all looking forward to the prompt return of our invested capital,” said Jay Frederick, an investor in Little Rock, Ark. In early 2021, the Securities and Exchange Commission brought fraud charges against GPB involving around $1.7 billion in investments in what New York’s attorney general described as a “Ponzi-like scheme” that used investor funds to cover promised 8% investment returns. The civil complaint followed criminal indictments against GPB’s founder, a senior executive and the firm’s principal marketer in January 2021.

SEC Head Warns Against ‘AI Washing,’ the High-Tech Version of ‘Greenwashing’

Submitted by jhartgen@abi.org on

Securities and Exchange Commission Chair Gary Gensler has warned businesses against “AI washing,” or making false artificial intelligence-related claims, likening it to the greenwashing phenomenon that has been the target of an agency crackdown, the Wall Street Journal reported. Gensler said yesterday that securities laws bar phony claims and require companies to give “full, fair and truthful” disclosures. “Don’t do it,” Gensler said at a conference hosted by The Messenger, a news outlet. “One shouldn’t greenwash and one shouldn’t AI wash.” “AI washing” has emerged as an informal term that describes businesses’ making unfounded AI claims to the public, akin to greenwashing, which refers to companies making unfounded representations about environmental sustainability. The explosive growth in the number and sophistication of AI applications has led to concerns that marketing claims might not match what companies are delivering. The Federal Trade Commission in February warned companies across the economy that it would be on the lookout for bogus AI claims in advertising, from exaggerations of AI-powered products’ capabilities to outright fabrications that a product incorporates AI technology.

Co-Chairs’ Corner

We are closing to books on an eventful 2023 and looking forward to a busy 2024. Between the travails of FTX and the numerous lesser frauds, the expertise of our members is in constant demand. This coming year, we plan to host webinars and committee video calls, which will resemble webinars but will be interactive. The plan for the video calls is to have short presentations on topics of interest (10 minutes maximum), followed by a group discussion. Some of our favorite classes this year were seminars rather than lectures.

The Supreme Court Expands the Fraud Exception to Discharge — Maybe

The Supreme Court may have expanded the types of debts that are exempt from discharge under § 523 of the Code. In Bartenwerfer v. Buckley [1], the Court held that § 523 bars the discharge of a debt arising from fraud committed by the debtor’s business partner. While this result appears to be both straightforward and uncontroversial, the broad language used by the Court raises the possibility of expanded objections to dischargeability under § 523.