Owner of Two Miami Home Health Agencies Sentenced to More Than Six Years in Prison for Role in $74 Million Medicare Fraud Conspiracy

The owner and operator of two defunct Miami home health agencies was sentenced today to 80 months in prison for her role in a $74 million conspiracy to defraud the Medicare program.

Acting U.S. Attorney Benjamin G. Greenberg of the Southern District of Florida, Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division, Special Agent in Charge George L. Piro of the FBI’s Miami Field Office, and 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 Regional Office, made the announcement.

Sila Luis, 59, of Miami, Florida, was sentenced by U.S. District Judge Marcia G. Cooke of the Southern District of Florida.  Judge Cooke also ordered the defendant to pay $45 million in restitution and to forfeit the gross proceeds traced to the offense.  Luis pleaded guilty on June 28, to one count of conspiracy to commit health care fraud. 

As part of her guilty plea, Luis admitted that, between January 2006 and June 2012, she and her co-conspirators agreed to, and actually did, operate LTC Professional Consultants Inc. (LTC) in order to fraudulently bill the Medicare program for home health care services, including diabetic injections, skilled nursing visits, physical therapy, and other treatments and services.  Professional Home Care Solutions Inc. was another home health agency under Luis’s ownership and control that was involved in the conspiracy.  Luis further admitted that she and her co-conspirators enlisted and paid patient recruiters kickbacks and bribes in exchange for the referral of Medicare beneficiaries to LTC.  Had Medicare known that Luis paid bribes and kickbacks to attract beneficiaries to her facilities, Medicare would not have paid any claims submitted on behalf of those beneficiaries.

Judge Cooke determined at sentencing that Luis was responsible for an intended loss of $74 million to the Medicare program.

Luis was charged along with Elsa Ruiz, 49, and Myriam Acevedo, 68, both of Miami, Florida, in an indictment returned on Oct. 3, 2012.  Acevedo pleaded guilty in May 2013 to conspiracy to pay health care kickbacks and payment of kickbacks in connection with a federal health care benefit program.  She was sentenced to 60 months in prison and ordered to pay $27 million in restitution.  Ruiz pleaded guilty to conspiracy to commit health care fraud.  She was sentenced to 80 months in prison and ordered to pay $45 million in restitution. 

The FBI and HHS-OIG investigated this case.  Trial Attorneys David Snider, Patrick Mott, and L. Rush Atkinson of the Criminal Division’s Fraud Section are prosecuting the case.

The Fraud Section leads the Medicare Fraud Strike Force, which is part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country.  The Medicare Fraud Strike Force operates in nine locations nationwide.  Since its inception in March 2007, the Medicare Fraud Strike Force has charged over 3,500 defendants who collectively have falsely billed the Medicare program for over $12.5 billion.

Related court documents and information may be found on the website of the District Court for the Southern District of Florida at www.flsd.uscourts.gov or on http://pacer.flsd.uscourts.gov.