Owner of Miami Home Health Agency Sentenced to More Than Nine Years in Prison for Role in $15 Million Medicare Fraud Conspiracy

The owner and operator of a defunct Miami, Florida home health agency was sentenced to 115 months in prison today for his role in a $15 million conspiracy to defraud the Medicare program. 

Acting Assistant Attorney General John P. Cronan of the Justice Department’s Criminal Division, Acting U.S. Attorney Benjamin G. Greenberg of the Southern District of Florida, Special Agent in Charge George L. Piro of the FBI’s Miami Field Office, Special Agent in Charge Shimon R. Richmond of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Miami Field Office and Special Agent in Charge Brian Swain of the U.S. Secret Service’s (USSS) Miami Field Office made the announcement.

Yunesky Fornaris, 38, of Miami, was sentenced by U.S. District Judge Joan A. Lenard of the Southern District of Florida, who also ordered Fornaris to pay $15.1 million in restitution and forfeit the gross proceeds traced to the offense.  Fornaris pleaded guilty on Oct. 3 to one count of conspiracy to commit wire fraud.

As part of his guilty plea, Fornaris admitted that between April 2010 and July 2016, he owned, controlled, and managed the business at Elite Home Care LLC (Elite), and that he and his co-conspirators submitted false and fraudulent home health care claims from Elite to the Medicare program via interstate wire.  Fornaris further admitted to concealing his true ownership interest in Elite by not listing his ownership interest on the Medicare enrollment application and to enlisting patient recruiters to recruit patients to Elite in exchange for illegal bribes and kickbacks.

Fornaris admitted that he knew or had reason to believe that most of Elite’s patients were not eligible to receive home health services because they were not homebound.  Had Medicare known that Fornaris paid bribes and kickbacks to attract beneficiaries to Elite, Medicare would not have paid any claims submitted on behalf of those beneficiaries.     

The FBI, HHS-OIG and USSS investigated this case.  Senior Litigation Counsel John A. Michelich and Trial Attorney Adam G. Yoffie of the Criminal Division’s Fraud Section and Assistant U.S. Attorney Lisa H. Miller of the Southern District of Florida, a former Fraud Section trial attorney, prosecuted the case.

The Fraud Section leads the Medicare Fraud Strike Force.  Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged nearly 3,500 defendants who have collectively billed the Medicare program for more than $12.5 billion.  In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.