Insurance Fraud NEWS
Home-health firm pays kickbacks for $8.6M of services in Florida
December 04, 2018, Miami, FL
Two Miami, Florida residents pleaded guilty today to health care fraud charges for their roles in an $8.6 million health care fraud scheme.
Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Ariana Fajardo Orshan of the Southern District of Florida, Special Agent in Charge George L. Piro of the FBI’s Miami Field Office, Special Agent in Charge Shimon R. Richmond of the Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Miami Regional Office and Miami Air and Marine Branch Director Martin G. Wade of the U.S. Customs and Border Protection (CBP) Air and Marine Operations made the announcement.
Alexander Ros Lazo, 54, an owner and operator of T.L.C. Health Services Inc., a home health agency, pleaded guilty to one count of conspiracy to commit health care fraud before U.S. District Judge Jose E. Martinez of the Southern District of Florida. Misleidy Ibarra, 46, also of Miami, a licensed massage therapist, pleaded guilty before Judge Martinez to one count of conspiracy to commit health care fraud. Sentencing has been scheduled for Feb. 5, 2019 before Judge Martinez.
As part of his guilty plea, Ros Lazo admitted that he paid kickbacks and bribes to his co-conspirators in exchange for home health services prescriptions and the referral of Medicare beneficiaries to T.L.C. Health Services, a company based in Miami. He further admitted that he and his co-defendant, Misleidy Ibarra, agreed with their co-conspirators to commit health care fraud by arranging for Ibarra to render therapy services on behalf of licensed therapists despite the fact that they knew she was not licensed to render the physical and occupational therapy services to the Medicare beneficiaries and billed Medicare for those services. As part of her guilty plea, Ibarra admitted to conspiring with Ros Lazo to commit health care fraud by rendering physical therapy services to Medicare beneficiaries when Ibarra was not licensed to provide these services. Ros Lazo admitted that as a result of the fraudulent claims, Medicare paid $8.6 million in benefits that it otherwise would not have. Ros Lazo was charged along with Ibarra in an indictment returned on June 21, 2018.
The case was investigated by the FBI, HHS-OIG and CBP Air and Marine Operations. Trial Attorney Alexander Kramer of the Criminal Division’s Fraud Section and Assistant U.S. Attorney Yisel Valdes of the Southern District of Florida are prosecuting the case.
The Fraud Section leads the Medicare Fraud Strike Force, which is part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. Since its inception in March 2007, the Medicare Fraud Strike Force, which maintains 14 strike forces operating in 23 districts, has charged nearly 4,000 defendants who have collectively billed the Medicare program for more than $14 billion.
Source: United States Department of Justice