Medical Clinic Owner Sentenced for Role in Multiple Health Care Fraud Schemes Totaling More Than $20 Million
|U.S. Department of Justice March 14, 2014|
WASHINGTON—The owner and operator of a Miami medical clinic, Merfi Corp., was sentenced today to serve 108 months in prison for her participation in multiple health care fraud schemes.
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; Special Agent in Charge George L. Piro of the FBI’s Miami Field Office; and Acting Special Agent in Charge Brian P. Martens of the U.S. Department of Health and Human Services-Office of Inspector General (HHS-OIG) Office of Investigations Miami Office made the announcement.
Isabel Medina, 49, of Miami, was sentenced by U.S. District Judge Ursula Ungaro of the Southern District of Florida. In addition to her prison term, Medina was also sentenced to serve three years of supervised release and was ordered to pay $8,437,393 in restitution.
On January 7, 2014, Medina pleaded guilty before Judge Ungaro to conspiracy to commit health care fraud.
According to court documents, Medina was an owner and operator of Merfi Corp., a Miami medical clinic that employed physicians, physician assistants, and other medical professionals who were authorized by law to dispense prescriptions for home health care services. Through Merfi Corp., Medina and her co-conspirators provided fraudulent home health and therapy prescriptions to the owners and operators of Flores Home Health Care Inc. and other home health care agencies, as well as to patient recruiters, in return for kickbacks and bribes.
Flores Home Health and these other home health care agencies purported to provide home health and therapy services to Medicare beneficiaries, but were in fact operated for the purpose of billing Medicare for, among other things, expensive physical therapy and home health care services that were not medically necessary and/or were not provided.
Medina has acknowledged that her involvement in fraudulent schemes at multiple home health care companies resulted in losses to the Medicare program exceeding $20 million.
The case is being 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 Trial Attorney A. Brendan Stewart of the Criminal Division’s Fraud Section.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,700 defendants who have collectively billed the Medicare program for more than $5.5 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with 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.