Ten Individuals Indicted in Medicare Fraud Scheme
| U.S. Attorney’s Office April 08, 2014 |
Wifredo A. Ferrer, United States Attorney for the Southern District of Florida; Ronald J. Verrochio, Inspector in Charge, U.S. Postal Inspection Service (USPIS); Brian P. Martens, Acting Special Agent in Charge, U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG); and George L. Piro, Special Agent in Charge, Federal Bureau of Investigation (FBI), Miami Field Office, announced that nine residents of Miami-Dade County and a resident of Hillsborough County have been indicted for their alleged participation in a $12.5 million Medicare fraud scheme.
On March 20, 2014, a federal grand jury in Miami returned a 59-count indictment charging Vicente Diaz, 39; Daniel Ocampo, 35; Elsa Capo, 71; Santiago Sepulveda, 79; Marta Curbeco, 67; Margarita Rodriguez, 72; Francisco Maysonet, 67; Pedro Peralta, 69; Amira Galan, 79; and Ana Rosa Santana, 77, for allegedly participating in a scheme to defraud Medicare by submitting false and fraudulent claims and the payment and receipt of kickbacks in connection with a federal health care program from approximately November 2011 to October 2013.
All 10 defendants are charged with conspiracy to commit health care fraud and wire fraud and conspiracy to pay and receive bribes and kickbacks in connection with a federal health care program. Diaz is additionally charged with nine counts of health care fraud and 19 counts of paying kickbacks and bribes in connection with a federal health care program. Ocampo is additionally charged with nine counts of health care fraud and 13 counts of paying kickbacks and bribes in connection with a federal health care program. Capo, Sepulveda, Curbeco, Rodriguez, Maysonet, Peralta, Galan, and Santana are charged with one count of health care fraud and various counts of receiving kickbacks and bribes in exchange for serving as patients of Marcialed Health Care Corp. (Marcialed) and Sacred Health Inc. (Sacred Health). Curbeco, Rodriguez, and Peralta are also charged with soliciting and accepting kickbacks and bribes in exchange for referring other beneficiaries to serve as patients of Marcialed and Sacred Health.
The allegations center on the operation of Marcialed and Sacred Health, two companies located in Miami-Dade County that were purportedly in the business of providing home health care to Medicare beneficiaries.
According to the indictment, Diaz controlled Marcialed and Sacred Health. Ocampo was for a time an officer of Sacred Health. Diaz and Ocampo offered and paid kickbacks and bribes to patient recruiters in return for referring beneficiaries to serve as patients so that Marcialed and Sacred could bill Medicare for home health services that were not medically necessary and were not provided. Curbeco, Rodriguez, and Peralta solicited and accepted kickbacks and bribes in exchange for referring beneficiaries to serve as patients of Marcialed and Sacred Health. Capo, Sepulveda, Curbeco, Rodriguez, Maysonet, Peralta, Galan, and Santana are Medicare beneficiaries who solicited and accepted kickbacks in return for agreeing to serve as patients of Maricaled and Sacred Health so that the companies could bill Medicare for home health services that were not medically necessary and were not provided.
The indictment alleges that the defendants falsified and caused to be falsified records to document the receipt of home health services from Marcialed and Sacred Health that were not provided and were not medically necessary. Diaz and Ocampo violated Medicare rules and regulations by offering and paying kickbacks and bribes to patient recruiters in exchange for the referral of beneficiaries to Marcialed and Sacred Health. Diaz and Ocampo then caused Marcialed and Sacred Health to submit false and fraudulent claims seeking payment from Medicare for the home health services which had purportedly been provided to beneficiaries, when in truth the services had not been provided and were not medically necessary. The indictment alleges that as a result of the fraudulent claims, Diaz and Ocampo caused Medicare to pay approximately $7,809,243 to Marcialed and $4,694,834 to Sacred Health.
The indictment alleges that Diaz, Ocampo, and other conspirators used the money fraudulently obtained from Medicare for their personal use and to further the fraud. The indictment seeks forfeiture of two properties and four Mercedes vehicles.
Mr. Ferrer commended the investigative efforts of U.S. Postal Inspection Service, HHS-OIG, and the FBI. This case is being prosecuted by Assistant U.S. Attorney Eric E. Morales and was brought as part of the Medicare Fraud Strike Force.
An indictment is only an accusation, and a defendant is presumed innocent unless and 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 www.usdoj.gov/usao/fls.