Miami Nurse Convicted of Health Care Fraud and False Statements Regarding Health Care Matters

Wifredo A. Ferrer, United States Attorney for the Southern District of Florida; John V. Gillies, Special Agent in Charge, Federal Bureau of Investigation, Miami Field Office; and Christopher B. Dennis, Special Agent in Charge, U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), Office of Investigations, Miami Regional Office, announced that a federal jury in Miami found Armando Santos, of Miami, guilty of health care fraud and making false statements related to health care matters. After a three-day trial, the jury convicted Santos today of one count of conspiracy to commit health care fraud, in violation of Title 18, United States Code, Section 1349; four counts of health care fraud, in violation of Title 18, United States Code, Section 1347, and two counts of false statements related to health care matters, in violation of Title 18, United States Code, Section 1035.

Sentencing will be scheduled in August 2011 before Chief U.S. District Judge Federico Moreno. Santos faces a statutory maximum of 10 years’ imprisonment as to each of the fraud charges, and five years imprisonment as to each of the false statement charges.

According to the evidence presented at trial, Santos was a registered nurse employed by a Miami-Dade based home health care agency. As part of his job as a home health nurse, Santos was paid to provide skilled nursing services to Medicare beneficiaries that were homebound, diabetic, insulin-dependent, and so ill that they were unable to inject themselves with insulin. Under Medicare regulations, Santos was required to keep records of each time he provided a skilled nursing service to a Medicare beneficiary. Between June 27, 2007, and March 13, 2009, Santos completed hundreds of documents in which he claimed that he had injected Medicare beneficiaries with insulin two times a day, seven days per week.

At trial, however, the evidence showed that at least two of the Medicare beneficiaries that the defendant claimed to be injecting with insulin twice daily, seven days per week, were neither in need of insulin nor homebound. The evidence also showed that the defendant claimed to be treating two separate Medicare beneficiaries at the same time. The defendant’s false statements resulted in the submission of $230,315 in false claims to Medicare for services that were either not medically necessary or actually provided to Medicare beneficiaries.

Mr. Ferrer commended the investigative efforts of the FBI and HHS-OIG. This case was prosecuted by Assistant U.S. Attorneys H. Ron Davidson and Michael O’Leary.

A copy of this press release may be found on the website of the United States Attorney’s Office for the Southern District of Florida at www.usdoj.gov/usao/fls. Related court documents and information may be found on the website of the United States District Court for the Southern District of Florida at www.flsd.uscourts.gov or http://pacer.flsd.uscourts.gov.