Tuesday, August 26, 2014

Co-Owner of Florida Home Health Company Sentenced to Serve 70 Months in Federal Prison and Ordered to Pay $6.2 million in Restitution for Participation in a Health Care Fraud Scheme Where Services Were Medically Unnecessary, Services Were Not Provided, Kickbacks Were Paid, And Patient Documentation Falsified

The criminal cases against home health owners continue to increase. On August 26, 2014, a co-owner of Professional Medical Home Health LLC, Annarella Garcia, 44, of Florida was sentenced to serve 70 months in prison and ordered to pay $6.2 million in restitution for her participation in a health care fraud scheme involving the now defunct home health care company. U.S. District Judge Federico A. Moreno of the Southern District of Florida imposed the sentence.

According to court documents, Ms. Garcia was a co-owner of Professional Medical Home Health, a Miami home health care agency that purported to provide home health and therapy services to Medicare beneficiaries.  On June 25, 2014, Ms. Garcia pleaded guilty to conspiracy to commit health care fraud.  Ms. Garcia admitted in her plea that between December 2008 and February 2014, she and others were engaged in a scheme to bill the Medicare Program for expensive physical therapy and home health care services that were not medically necessary or were not provided.   During that time, Professional Medical Home Health was paid approximately $6.25 million by Medicare for the fraudulent claims.

Specifically, Ms. Garcia admitted that she and her co-conspirators paid kickbacks and bribes to patient recruiters in return for their providing patients to Professional Medical Home Health for home health and therapy services that were not medically necessary or were not provided.   In furtherance of the scheme, Ms. Garcia admitted that she and her co-conspirators falsified patient documentation to make it appear that beneficiaries qualified for and received home health care services, when, in fact, many of the beneficiaries did not actually qualify for such services and did not receive such services.

Attorney Commentary:  This is a lengthy sentence for a plea. The determining factor may have been that in the Indictment there was a money laundering count due to cashing checks for cash that gave exposure up to 20 years' in prison while the health care fraud charge carries a maximum of 10 years. The plea was to the conspiracy to commit health care fraud which saved exposure on the money laundering count.  There were also false statement charges that could carry additional consecutive time. This case moved quite quickly from indictment to plea to sentence, just over 3 months.  

Posted by Tracy Green, Esq.
Office: 213-233-2260
Email: tgreen@greenassoc.com
Green and Associates, Attorneys at Law


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