Owner of Miami Home Health Company Pleads Guilty for Role in $6.9 Million Medicare Fraud Scheme
WASHINGTON—The owner of a Miami home health care agency pleaded guilty today in connection with a $6.9 million Medicare fraud scheme.
Assistant Attorney General Leslie R. Caldwell 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 Special Agent in Charge Derrick Jackson of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Miami Regional Office made the announcement.
Orelvis Olivera, 45, of Miami, pleaded guilty to one count of conspiracy to commit health care fraud before U.S. District Judge Robert N. Scola Jr. of the Southern District of Florida. A sentencing hearing is scheduled for April 21, 2015.
According to his plea documents, Olivera was an owner and operator of Acclaim Home Healthcare Inc. (Acclaim Home Health), a Miami home health care agency that purported to provide home health and therapy services to Medicare beneficiaries. Olivera admitted that he and his co-conspirators operated Acclaim Home Health 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.
Olivera further admitted that he paid kickbacks and bribes to patient recruiters in exchange for patient referrals, as well as prescriptions, plans of care (POCs) and certifications for medically unnecessary therapy and home health services for Medicare beneficiaries. Olivera admitted that he and his co-conspirators used these prescriptions, POCs and medical certifications to fraudulently bill the Medicare program for home health care services.
From May 2008 to September 2014, Acclaim Home Health billed Medicare approximately $6.9 million for fraudulent claims, and was paid approximately $5.7 million for the same.
The 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 Trial Attorney Kelly Graves 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 nearly 2,100 defendants who have collectively billed the Medicare program for more than $6.5 billion. In addition, the HHS Centers for Medicare & 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.