WASHINGTON – Two owners of a Miami home health care agency were sentenced to 73 and 74 months in prison, respectively, for their participation in a $20 million home health Medicare fraud scheme, announced the Department of Justice, the FBI and the Department of Health and Human Services (HHS).
U.S. District Judge Marcia G. Cooke in the Southern District of Florida sentenced Ariel Rodriguez to 73 months in prison and three years of supervised release and Reynaldo Navarro to 74 months in prison and three years of supervised release. Rodriguez and Navarro were each ordered to pay $14 million in restitution, joint and several with co-defendants.
Two co-defendants, Melissa Rodriguez and Ysel Salado were also sentenced today by Judge Cooke to four years of probation.
Ariel and Melissa Rodriguez, Navarro and Salado each pleaded guilty last year to one count of conspiracy to commit health care fraud. Ariel Rodriguez, 41, and Navarro, 37, were the owners of Serendipity Home Health Inc., a Florida home health agency that purported to provide home health care and physical therapy services to eligible Medicare beneficiaries. Melissa Rodriguez, 24, and Salado, 26, were office workers for Serendipity.
According to plea documents, Ariel Rodriguez and Navarro conspired with patient recruiters to bill the Medicare program for unnecessary home health care and therapy services. Ariel Rodriguez, Navarro and their co-conspirators paid kickbacks and bribes to patient recruiters in return for the recruiters providing patients to Serendipity, as well as prescriptions, plans of care (POCs) and certifications for medically unnecessary therapy and home health services for Medicare beneficiaries. Ariel Rodriguez and Navarro used these prescriptions, POCs and medical certifications to fraudulently bill Medicare for home health care services, which Ariel Rodriguez and Navarro knew was in violation of federal criminal laws. Melissa Rodriguez and Salado cashed checks from Serendipity and provided this cash to Ariel Rodriguez and Navarro knowing it would be used to pay the kickbacks and bribes to the patient recruiters.
According to plea documents, at Serendipity, nurses and office staff falsified patient files for Medicare beneficiaries to make it appear that the beneficiaries qualified for home health care and therapy services from Serendipity when, in fact, Ariel Rodriguez and Navarro knew that the beneficiaries did not actually qualify for and did not receive such services. Ariel Rodriguez and Navarro knew that these files were falsified so that Medicare could be billed for medically unnecessary therapy and home health related services.
From approximately April 2007 through March 2009, Ariel Rodriguez, Navarro and their co-conspirators submitted approximately $20 million in false and fraudulent claims to Medicare. Medicare paid approximately $14 million on those claims.
Today’s sentences were announced by Assistant Attorney General Lanny A. Breuer of the Justice Department’s Criminal Division; U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida; John V. Gillies, Special Agent-in-Charge of the FBI’s Miami Field Office; and Special Agent-in-Charge Christopher Dennis of the HHS Office of Inspector General (HHS-OIG), Office of Investigations Miami Office.
This case is being prosecuted by Senior Trial Attorney Joseph S. Beemsterboer of the Criminal Division’s Fraud Section. The case was investigated by the FBI and HHS-OIG, and was brought as a part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida.
Since their inception in March 2007, Medicare Fraud Strike Force operations in nine locations have charged more than 1,330 defendants who collectively have falsely billed the Medicare program for more than $4 billion. In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to: www.stopmedicarefraud.gov.