Administrator and Employee of Two Miami Home Health Companies Sentenced for Role in $74 Million Health Care Fraud Scheme
|U.S. Department of Justice October 23, 2013|
WASHINGTON—The administrator and employee of two Miami health care companies was sentenced today to serve 60 months in prison for her participation in a $74 million home health Medicare fraud scheme.
Acting Assistant Attorney General Mythili Raman of the Criminal Division, U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida, Special Agent in Charge Michael B. Steinbach of the FBI’s Miami Field Office, and Special Agent in Charge Christopher Dennis of the HHS Office of Inspector General (HHS-OIG), Office of Investigations, Miami Office, made the announcement.
Myriam Acevedo, 63, of Miami, was sentenced by U.S. District Judge Marcia G. Cooke in the Southern District of Florida. In May 2013, Acevedo pleaded guilty, without a plea agreement, to one count of conspiracy to pay health care kickbacks and two counts of payment of health care kickbacks.
According to court documents, Acevedo was an administrator of LTC Professional Consultants Inc. (LTC) and an employee of Professional Home Care Solutions Inc. (Professional), Miami home health care agencies that purported to provide home health and therapy services to Medicare beneficiaries. Acevedo and her co-conspirators agreed to and actually did operate LTC and Professional for the purpose of billing the Medicare program for, among other things, expensive physical therapy and home health care services that were not medically necessary and/or were not provided.
Acevedo’s primary role in the scheme was to pay kickbacks and bribes to patient recruiters of LTC and Professional. As part of this role, Acevedo and others would distribute cash to patient recruiters in exchange for providing patients to LTC and Professional, as well as prescriptions, plans of care (POCs), and certifications for medically unnecessary therapy and home health services for Medicare beneficiaries. Acevedo and her co-conspirators would use these prescriptions, POCs, and medical certifications to fraudulently bill the Medicare program for home health care services, which Acevedo knew was in violation of federal criminal laws.
From approximately September 2007 through June 2012, LTC and Professional submitted approximately $41 million in claims for home health services that were not medically necessary and/or not provided. Medicare actually paid approximately $27 million for these fraudulent claims. Acevedo was part of an overall scheme that fraudulently billed Medicare more than $74 million.
This 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 Assistant Chief Joseph S. Beemsterboer of the Criminal Division’s Fraud Section.
Since their inception in March 2007, Medicare Fraud Strike Force operations in nine locations have charged more than 1,500 defendants who collectively have falsely billed the Medicare program for more than $5 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.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to: www.stopmedicarefraud.gov.