Tuesday, March 26, 2013

Vladimir Jimenez Sentenced to 36 Months in $20 Million Health Care Fraud Scheme

Source- http://www.justice.gov/opa/pr/2013/April/13-crm-370.html

A patient recruiter for a Miami health care company was sentenced today to serve 36 months in prison for his participation in a $20 million home health Medicare fraud scheme, announced Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division; U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida; Michael B. Steinbach, Special Agent in Charge of the FBI’s Miami Field Office; and Special Agent in Charge Christopher Dennis of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), Office of Investigations Miami Office.

Vladimir Jimenez, 43, was sentenced by U.S. District Judge Joan A. Lenard in the Southern District of Florida. In addition to his prison term, Jimenez was sentenced to serve two years of supervised release and ordered to pay $950,000 in restitution, jointly and severally with co-defendants.

In January 2013, Jimenez pleaded guilty to one count of conspiracy to receive health care kickbacks.

According to court documents, Vladimir Jimenez was a patient recruiter who worked for Serendipity Home Health, a Miami home health care agency that purported to provide home health and therapy services to Medicare beneficiaries.

According to court documents, from approximately April 2007 through approximately March 2009, Jimenez recruited patients for Serendipity, and in doing so solicited and received kickbacks and bribes from the owners and operators of Serendipity in return for allowing Serendipity to bill the Medicare program on behalf of the patients Jimenez had recruited. These Medicare beneficiaries were billed for home health care and therapy services that were medically unnecessary and/or not provided.

From approximately January 2006 through March 2009, Serendipity submitted approximately $20 million in claims for home health services that were not medically necessary and/or not provided. Medicare actually paid approximately $14 million for these fraudulent claims.

As a result of Jimenez’s participation in the illegal scheme, the Medicare program was fraudulently billed more than $400,000 for purported home health care services.

In a related case, on June 21, 2012, Ariel Rodriguez and Reynaldo Navarro, the owners and operators of Serendipity, were sentenced to 73 and 74 months in prison, respectively, following guilty pleas in March 2012 to one count each of conspiracy to commit health care fraud.

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