Miami Husband and Wife Charged with Home Health Care Fraud

Wifredo A. Ferrer, United States Attorney for the Southern District of Florida; John V. Gillies, Special Agent in Charge, Federal Bureau of Investigation (FBI), Miami Field Office; and Christopher B. Dennis, Special Agent in Charge, U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), Office of Investigations, Miami Regional Office, announced the indictment of Elizabeth Acosta Sanz and Luis Alejandro Sanz, both of Miami, Florida, on charges of conspiracy to commit health care fraud, health care fraud, conspiracy to pay kickbacks, the payment of kickbacks, conspiracy to commit money laundering, and money laundering, in violation of Title 18, United States Code, Sections 1349, 1347, 371 and 1956, respectively.

According to charges, the defendants, husband and wife, owned Ideal Home Health, a Miami-Dade home health agency that purportedly provided skilled nursing services to homebound Medicare beneficiaries. The indictment alleges that the defendants used Ideal submit fraudulent claims to Medicare for home health services that were neither medically necessary nor actually provided to Medicare beneficiaries.

More specifically, the indictment alleges that from August 2006 through March 2009, the defendants offered and paid kickbacks to recruiters and others. These individuals, in turn, paid Medicare beneficiaries to induce them to agree to be serviced by Ideal. In addition, the defendants instructed nurses to falsify patient medical records to make it appear that the Medicare beneficiaries qualified for and received home health services. In fact, however, the services were not medically necessary and had not been provided.

In total, the defendants submitted approximately $11,340,342 in false claims to Medicare, of which Medicare paid $7,317,879. According to the criminal complaint, $1.6 million in checks were written to Elizabeth Acosta Sanz and $1.6 million in checks were written to Luis Alejandro Sanz.

Mr. Ferrer commended the investigative efforts of the FBI and HHS-OIG. This case is being prosecuted by Assistant U.S. Attorney Daniel Bernstein.

An indictment is only an accusation and the defendants are presumed innocent until proven guilty.

A copy of this press release may be found on the website of the United States Attorney’s Office for the Southern District of Florida at http://www.usdoj.gov/usao/fls. Related court documents and information may be found on the website of the District Court for the Southern District of Florida at http://www.flsd.uscourts.gov or on http://pacer.flsd.uscourts.gov.