Owner of Two Miami Home Health Agencies Sentenced- $74 Million Medicare Fraud Conspiracy

[nitpicker]

https://www.justice.gov/opa/pr/owner-two-miami-home-health-agencies-sentenced-more-six-years-prison-role-74-million-medicare

Department of Justice
Office of Public Affairs

FOR IMMEDIATE RELEASE
Tuesday, November 21, 2017

Owner of Two Miami Home Health Agencies Sentenced to More Than Six Years in Prison for Role in $74 Million Medicare Fraud Conspiracy

The owner and operator of two defunct Miami home health agencies was sentenced today to 80 months in prison for her role in a $74 million conspiracy to defraud the Medicare program.
(snip)

Sila Luis, 59, of Miami, Florida, was sentenced by U.S. District Judge Marcia G. Cooke of the Southern District of Florida. Judge Cooke also ordered the defendant to pay $45 million in restitution and to forfeit the gross proceeds traced to the offense. Luis pleaded guilty on June 28, to one count of conspiracy to commit health care fraud.

As part of her guilty plea, Luis admitted that, between January 2006 and June 2012, she and her co-conspirators agreed to, and actually did, operate LTC Professional Consultants Inc. (LTC) in order to fraudulently bill the Medicare program for home health care services, including diabetic injections, skilled nursing visits, physical therapy, and other treatments and services. Professional Home Care Solutions Inc. was another home health agency under Luis’s ownership and control that was involved in the conspiracy. Luis further admitted that she and her co-conspirators enlisted and paid patient recruiters kickbacks and bribes in exchange for the referral of Medicare beneficiaries to LTC. Had Medicare known that Luis paid bribes and kickbacks to attract beneficiaries to her facilities, Medicare would not have paid any claims submitted on behalf of those beneficiaries. Judge Cooke determined at sentencing that Luis was responsible for an intended loss of $74 million to the Medicare program.
(snip)

[mitch96]

1. When I worked in Miami.. this was SOP for these clinics

One owner told me if the government is so stupid to THROW money at him, why not catch it??
At one place they would have a bunch of vans and pick up the "abuelas" and bring them to the clinic. Do just a few tests they did not need and charge for a lot more that weren't done. Ply them with a cafecito and pastellas for "free" and take them home. The old folks would sit around and chat all morning and then get driven home.. The afternoon shift would pick up another batch later..
What a scam and no oversight...
m