Medicare Fraud Arrests: More Than 30 Busted in Miami in Nationwide Takedown - NBC 6 South Florida

Medicare Fraud Arrests: More Than 30 Busted in Miami in Nationwide Takedown

32 Miami suspects charged with fraud totaling more than $200 million



    More than 30 South Florida suspects were arrested Thursday in a massive nationwide roundup of health care fraudsters, authorities said.

    Federal officials say the 32 suspects from Miami are charged with fraud totaling more than $200 million. Authorities were at Professional Home Care Solutions removing boxes on Thursday.

    "I saw about 30 officers in front with their federal shirts on," Morgan Gregory said about a location off Bird Road and 72nd Avenue. "Guns and badges."

    The arrests were part of what U.S. Attorney General Eric Holder called "one of the largest health care fraud takedowns on record" during a Thursday afternoon news conference.

    According to Holder, members of the Medicare Fraud Strike Force made a series of coordinated arrests in seven states of suspects for their alleged participation in fraud schemes involving nearly $430 million in false billings.

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    The figure includes over $230 million in home health care fraud, more than $100 million in mental health care fraud and approximately $49 million in ambulance transportation fraud, which is the largest ambulance fraud scheme ever prosecuted by the strike force, Holder said.

    A total of 91 defendants, which include doctors, nurses and other licensed medical professionals, are facing charges of health care fraud, conspiracy to commit health care fraud, wire fraud, aggravated identity theft and money laundering related to billing Medicare for treatments or services not necessary or never rendered.

    "Such activities not only syphon precious taxpayer resources, drive up health care costs and jeopardize the strength of the Medicare program, they also disproportionally victimize the most vulnerable members of our society including the elderly, disabled and impoverished Americans," Holder said.

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    Some South Florida cases include:

    Vladimir Jimenez and Manuel Lozano, both patient recruiters for Serendipity Home Health, are accused of supplying patients in exchange for kickbacks and bribes. The company fraudulently billed Medicare for about $20 million for services that were not provided, the Department of Justice said. Each man faces up to five years per count if convicted.

    Orlando V. Torres is accused of submitting almost $5 million in claims to Medicare for services that were not necessary or not provided. M.B.M. Medical Services, Inc., which Torres owned, was subsequently paid over $3 million by Medicare, authorities said. Torres faces up to ten years in prison if convicted.

    Assistant Attorney General Lanny Breuer said in one case, the owners and operators of a Miami psychiatric hospital paid cash kickbacks to owners and operators of assisted living facilities and halfway houses to obtain patients, and then billed Medicare for over $67 million in mental health services that were unnecessary or never provided.

    They even tried to have the government reimburse them for the kickbacks by disguising them as legitimate expenses on cost reports submitted to Medicare, Breuer said.

    “Here in South Florida we must remain vigilant to address healthcare fraud in its many evolving forms,” said Christopher B. Dennis, of the U.S. Department of Health and Human Services. “When hospitals, home health agencies, pharmacies, or other healthcare providers are suspected of breaking the law, they should expect swift justice.”

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