WASHINGTON – An office manager for a Miami home health care agency was sentenced today to 78 months in prison for her participation in a $25 million home health Medicare fraud scheme, announced the Department of Justice, the FBI and the Department of Health and Human Services (HHS). Two of her co-defendants were also sentenced to prison today for their roles in the fraud scheme.
The defendants were sentenced by U.S. District Judge Joan A. Lenard in the Southern District of Florida.
Lisandra Alonso, 34, was sentenced to 78 months in prison and two years of supervised release and was ordered to pay $15.3 million in restitution.
Jose Ros, 72, was sentenced to 12 months in prison and three years of supervised release and was ordered to pay $395,000 in restitution.
Farah Maria Perez, 40, was sentenced to six months in prison and two years of supervised release and was ordered to pay $118,000 in restitution.
Alonso, Ros and Perez each pleaded guilty earlier this year to one count of conspiracy to commit health care fraud. They were each ordered to pay their restitution jointly and severally with co-conspirators and defendants in a related case.
According to court documents, Alonso was an office manager and patient recruiter for ABC Home Health Care Inc., a Miami home health care agency that purported to provide home health and physical therapy services to Medicare beneficiaries. Ros was a patient recruiter for both ABC and Florida Home Health Care Providers Inc., another related home health care agency. Perez was a registered nurse and a patient recruiter for Florida Home Health. According to court documents, ABC and Florida Home Health only existed to defraud Medicare.
Alonso, Ros and Perez admitted that beginning in approximately January 2006 and continuing until approximately March 2009, they recruited Medicare beneficiaries who would allow ABC and Florida Home Health to bill Medicare for home health care and therapy services that were medically unnecessary and/or never provided. Alonso, Ros and Perez solicited and received kickbacks and bribes from the owners and operators of ABC and Florida Home Health in return for the recruited patients. Alonso, Ros and Perez knew that the patients they recruited did not qualify for the services billed to Medicare and that the files for the recruited patients were falsified to make it appear that the patients qualified for the services.
According to court documents, Perez and her co-defendant nurses falsified patient files for Medicare beneficiaries to make it appear that the beneficiaries qualified for home health care and therapy services. Perez admitted that she knew the beneficiaries did not qualify for and did not receive the services. The files were falsified so that Medicare could be billed for medically unnecessary therapy and home health related services.
According to plea documents, as office manager, Alonso taught the owners and operators of ABC how to operate a fraudulent home health agency. Alonso explained the importance of recruiters, kickbacks, doctors, beneficiaries and Medicare billing. In this role, Alonso negotiated the kickback payment rates between the patient recruiters and the owners and operators of ABC. Alonso distributed the kickback payments to the patient recruiters on behalf of the owners and operators of ABC.
As office manager, Alonso also taught nurses at ABC how to falsify patient files for Medicare beneficiaries to make it appear that the beneficiaries qualified for home health care and therapy services when, in fact, she knew that the beneficiaries did not qualify for and did not receive such services.
As a result of the participation of Alonso, Ros and Perez in the illegal scheme, the Medicare program was billed approximately $17 million, $395,000 and $118,000, respectively, for purported home health care services that were not medically necessary and/or were not provided.
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Report Medicare & Medicaid Fraud by Calling 1-888-482-6825 or by visiting
www.usawhistleblower.com
Alonso, Ros and Perez each pleaded guilty earlier this year to one count of conspiracy to commit health care fraud. They were each ordered to pay their restitution jointly and severally with co-conspirators and defendants in a related case.
According to court documents, Alonso was an office manager and patient recruiter for ABC Home Health Care Inc., a Miami home health care agency that purported to provide home health and physical therapy services to Medicare beneficiaries. Ros was a patient recruiter for both ABC and Florida Home Health Care Providers Inc., another related home health care agency. Perez was a registered nurse and a patient recruiter for Florida Home Health. According to court documents, ABC and Florida Home Health only existed to defraud Medicare.
Alonso, Ros and Perez admitted that beginning in approximately January 2006 and continuing until approximately March 2009, they recruited Medicare beneficiaries who would allow ABC and Florida Home Health to bill Medicare for home health care and therapy services that were medically unnecessary and/or never provided. Alonso, Ros and Perez solicited and received kickbacks and bribes from the owners and operators of ABC and Florida Home Health in return for the recruited patients. Alonso, Ros and Perez knew that the patients they recruited did not qualify for the services billed to Medicare and that the files for the recruited patients were falsified to make it appear that the patients qualified for the services.
According to court documents, Perez and her co-defendant nurses falsified patient files for Medicare beneficiaries to make it appear that the beneficiaries qualified for home health care and therapy services. Perez admitted that she knew the beneficiaries did not qualify for and did not receive the services. The files were falsified so that Medicare could be billed for medically unnecessary therapy and home health related services.
According to plea documents, as office manager, Alonso taught the owners and operators of ABC how to operate a fraudulent home health agency. Alonso explained the importance of recruiters, kickbacks, doctors, beneficiaries and Medicare billing. In this role, Alonso negotiated the kickback payment rates between the patient recruiters and the owners and operators of ABC. Alonso distributed the kickback payments to the patient recruiters on behalf of the owners and operators of ABC.
As office manager, Alonso also taught nurses at ABC how to falsify patient files for Medicare beneficiaries to make it appear that the beneficiaries qualified for home health care and therapy services when, in fact, she knew that the beneficiaries did not qualify for and did not receive such services.
As a result of the participation of Alonso, Ros and Perez in the illegal scheme, the Medicare program was billed approximately $17 million, $395,000 and $118,000, respectively, for purported home health care services that were not medically necessary and/or were not provided.
***********************************************************************
Report Medicare & Medicaid Fraud by Calling 1-888-482-6825 or by visiting
www.usawhistleblower.com
