South florida defendant sentenced in medicare fraud case

December 24, 2010

Another South Florida resident received a significant prison sentence for his alleged involvement in a Medicare fraud scheme. The owner of clinic located in Miami, Florida, received a 60 month prison sentence for fraudulently billing Medicare for home health care services that were either unnecessary or in some instances never provided. After entering a guilty plea, the defendant appeared with his Miami criminal defense lawyer at his sentencing hearing where he was also ordered to perform two years of supervised release and pay $9.8 million in restitution to the federal government. Other defendants were also charged as co-conspirators in the Medicare fraud case.

The defendant purportedly admitted to the Medicare fraud by telling federal law enforcement authorities that he operated the clinic which provided home health care services and billed for unnecessary prescriptions, healthcare plans and medical certifications. The defendant's company submitted fraudulent medical records in order to submit bills to Medicare. The clinic was billing for insulin for patients who allegedly suffered from diabetes. Court records indicated that 344 prescriptions were billed to Medicare for unnecessary treatments or for treatments that were never provided to patients.

The clinic through the defendant billed Medicare for $16.8 million for home health care services. Medicare issued payments back to the clinic in the amount close to $10 million. A co-owner of the clinic had previously received the same sentence for his involvement in the case. Nurses who worked at the clinic also received prison sentences. Two of the nurses received 30 months in prison at their sentencing hearing, while a two other nurses received two and four month prison sentences. These nurses cooperated with federal law enforcement to received reduced sentences. All of the nurses were ordered to serve probation after their release and make restitution payments. The nurses admitted that they falsified records provided to Medicare that patients were receiving treatment and insulin injunctions, both of which never occurred.

The Medicare Fraud Strike Force conducted the investigation, while the case was prosecuted the U.S. Attorney's Office for the Southern District of Florida. Since inception of the strike force, they have been responsible for 825 indictments of defendants charged with fraudulently billing Medicare in excess of $2 billion. In effort to cut down on the fraud, the Health and Human Services Office of the Inspector General, the Human Health Care Centers of Medicare Services and the FBI are also investigating fraud claims. Medicare fraud is being taken seriously as the fraud eats into the country's budget. Any one being investigated or arrested for fraud related charges should immediately seek out a criminal defense law firm with experience in handling and defending these types of cases as the punishments and fines are severe.

Florida Clinic Owner Sentenced for Role in Medicare Fraud Scheme, 7th Space.com, December 21, 2010.