September 30, 2014

Miami Home Health Care Agency Owner Indicted in $8 Million Medicare Fraud Scheme

WASHINGTON—The owner of a Miami home health care agency has been arrested in connection with an $8 million health care fraud scheme involving Acclaim Home Healthcare Inc.

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 Acting 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.

In an indictment returned on Sept. 25, 2014, and unsealed today, Orelvis Olivera, 45, of Miami, was charged with conspiracy to commit health care and wire fraud, conspiracy to pay and receive kickbacks and paying and receiving kickbacks in connection with a federal health care benefit program.

According to the indictment, Acclaim Home Health was a Miami-based home health care agency that purported to provide home health care and physical therapy services to Medicare beneficiaries. Olivera allegedly paid kickbacks to patient recruiters in return for the recruiters’ referral of Medicare beneficiaries to Acclaim Home Health. In addition, Olivera allegedly solicited and received kickbacks in return for referring Medicare beneficiaries to other Miami-based home health care agencies.

As alleged in the indictment, from May 2008 to June 2014, Acclaim Home Health billed Medicare approximately $8 million for fraudulent claims, and was paid approximately $7.3 million by Medicare for those claims.

The charges contained in the indictment are merely accusations, and the defendant is presumed innocent unless and until proven guilty.

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 2,000 defendants who have collectively billed the Medicare program for more than $6 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 Team (HEAT), go to: www.stopmedicarefraud.gov.