FL Patient Recruiter Pleads Guilty in $25 Million Scam2, Insurance Fraud — By Trace America on November 9, 2011 at 2:25 PM
On November 8th, the Department of Justice, the FBI and the Department of Health and Human Services (HHS) announced that a patient recruiter from a Miami health care agency has pled guilty for her part in a $25 million home health Medicare fraud scheme.
According to the press release, Beatriz Torres-Cruz, 50, pleaded guilty before U.S. District Judge Joan A. Lenard in Miami to one count of conspiracy to commit health care fraud and one count of solicitation of health care kickbacks. Torres-Cruz was charged in a February 2011 indictment.
According to plea documents, Torres-Cruz was a patient recruiter for Florida Home Health Providers Inc., a Miami home health care agency that purported to provide home health and physical therapy services to Medicare beneficiaries. According to court documents, Florida Home Health billed the Medicare program for expensive physical therapy and home health care services that were medically unnecessary and/or never provided. Court documents allege that the medically unnecessary services were prescribed by doctors, including Jose Nunez, M.D.
Along with Torres-Cruz and 19 other co-conspirators, Nunez was also charged in the February 2011 indictment.
Torres-Cruz admitted that, beginning in approximately January of 2006 and lasting until approximately March of 2009, she, along with co-defendants, offered and paid kickbacks and bribes to Medicare beneficiaries in return for them allowing Florida Home Health to bill Medicare for services that were medically unnecessary and/or never provided. In return for her patient recruiting, Torres-Cruz solicited and received kickbacks and bribes from the owners and operators of Florida Home Health.
Torres-Cruz knew that the patients she recruited for Florida Home Health did not qualify for the services that were being billed to Medicare.
As a result of her participation in the scheme, Torres-Cruz caused Medicare to be billed for about $195,000 for purported home health care services that were not medically necessary and/or never happened.
Seventeen other co-conspirators have pleaded guilty for their roles in the fraud scheme, including Dr. Nunez.
Sentencing has been scheduled for January 30, 2012.
The charge of conspiracy to commit health care fraud carries a maximum prison sentence of 10 years and the charge of solicitation of health care kickbacks carries a maximum prison sentence of five years. The defendants could also face terms of supervised release, along with the forfeiture of any property or proceeds that they obtained through their criminal activities.
This post is authored by Trace America.