Three Patient Recruiters Sentenced in $20
Million Miami Health Care Fraud Scheme
Three
patient recruiters were sentenced to prison today for their participation in a
$20 million health care fraud scheme involving defunct home health care company
Trust Care Health Services Inc. (Trust Care).
Assistant
Attorney General Leslie R. Caldwell of the Justice Department’s Criminal
Division, U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida,Special Agent in Charge George L. Piro of the FBI’s Miami Field Office and
Acting Special Agent in Charge Derrick Jackson of the U.S. Department of Health
and Human Services Office of Inspector General’s (HHS-OIG) Miami Regional
Office made the announcement. U.S. District
Judge Darrin P. Gayles of the Southern District of Florida imposed the
sentences.
Estrella
Perez, 57, of Coral Gables, Florida, was sentenced to serve 37 months in
prison, followed by three years of supervised release, and ordered to pay
$1,172,162 in restitution.
Solchys Perez, 34, of Miami, was sentenced to serve 30 months in prison, followed by three years of supervised release, and ordered to pay $746,600 in restitution.
Solchys Perez, 34, of Miami, was sentenced to serve 30 months in prison, followed by three years of supervised release, and ordered to pay $746,600 in restitution.
Abigail Aguila, 40, of
Miami, was sentenced to serve 30 months in prison, followed by three years of
supervised release, and ordered to pay $491,438 in restitution.
On July 10, 2014, Estrella Perez and Solchys Perez pleaded guilty to conspiracy to commit health care fraud, and Aguila pleaded guilty to conspiracy to defraud the United States and receive health care kickbacks.
On July 10, 2014, Estrella Perez and Solchys Perez pleaded guilty to conspiracy to commit health care fraud, and Aguila pleaded guilty to conspiracy to defraud the United States and receive health care kickbacks.
According
to court documents, Estrella Perez, Solchys Perez, and Aguila recruited
patients for Trust Care, a Miami home health care agency, in exchange for
kickbacks paid in cash or by check to the defendants or their shell companies.
In turn, Trust Care billed the Medicare program for home health care and therapy services that were not medically necessary or were not provided.
In turn, Trust Care billed the Medicare program for home health care and therapy services that were not medically necessary or were not provided.
Estrella
Perez and Solchys Perez also paid kickbacks and bribes to co-conspirators in
doctors’ offices and clinics in exchange for home health and therapy
prescriptions, plans of care and medical certifications for their recruited
patients. Co-conspirators at Trust Care
then used these documents to fraudulently bill the Medicare program for
services.
From March
2007 through January 2010, Trust Care submitted approximately $20 million in
false claims for home health services.
Medicare paid Trust Care approximately $15 million for these fraudulent
claims.
On Sept.
16, 2014, another patient recruiter, Monica Macias, was sentenced to serve 24
months in prison for her participation in the same scheme.
The case
was investigated by the FBI and HHS-OIG and was brought as part of the Medicare
Fraud Strike Force, under the supervision of the Criminal Division’s Fraud
Section and the U.S. Attorney’s Office for the Southern District of
Florida. This case is being prosecuted
by Trial Attorneys A. Brendan Stewart and Anne P. McNamara of the Criminal
Division’s Fraud Section.
Since its
inception in March 2007, the Medicare Fraud Strike Force, now operating in nine
cities across the country, has charged nearly 2,000 defendants who have
collectively billed the Medicare program for more than $6 billion.
In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn
more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT),
go to: www.stopmedicarefraud.gov.
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