Administrator of Miami-Area Home Health Agency Sentenced to 126 Months in Prison for Involvement in $2.5 Million Medicare Fraud Scheme
Today, the administrator of a Miami-area home health agency was sentenced to a 126 month prison term for his role in a $2.5 million Medicare fraud scheme.
Acting Assistant Attorney General Kenneth A. Blanco of the Justice Department’s Criminal Division, U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida, Special Agent in Charge George L. Piro of the FBI’s Miami Division and Special Agent in Charge Shimon Richmond of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Miami Regional Office made the announcement.
Raciel Leon, 42, of Miami, was sentenced by U.S. District Judge William J. Zloch of the Southern District of Florida. In December 2016, he was convicted after a two-week jury trial of one count of conspiracy to commit health care fraud and wire fraud and one count of conspiracy to defraud the United States and pay and receive health care bribes and kickbacks.
According to evidence presented at trial, Leon was the manager of Mercy Home Care Inc. (Mercy) and a billing employee for D&D&D Home Health Care Inc. (DDD), both of which were home health agencies in Miami-Dade County, Florida. The evidence showed that Leon and his co-conspirators used the companies to submit false claims to Medicare that were based on services that were not medically necessary, not actually provided, and for patients that were procured through the payment of illegal kickbacks to doctors and patient recruiters. According to evidence presented at trial, Leon submitted claims to Medicare for beneficiaries who were admitted to Mercy and DDD only as a result of forged prescriptions and falsified medical documentation; backdated claims for services supposedly rendered years prior; and claims for beneficiaries who were coached to say they needed services, when in fact they were not homebound. Leon also destroyed evidence, including a kickback ledger, prior to his arrest.
The evidence introduced at trial further established that between Oct. 2014 and June 2015, Medicare paid approximately $2.5 million for false and fraudulent claims submitted by Mercy and DDD.
Ten of Leon’s co-conspirators previously pleaded guilty or were convicted at trial in this and other related cases filed in the Southern District of Florida.
The case was investigated by the FBI and the HHS-OIG and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida. Trial Attorneys Lisa Miller and Angela Adams of the Criminal Division’s Fraud Section are prosecuting the case.