Miami Medical Clinic Owner Pleads Guilty to Health Care Fraud Scheme
A Miami, Florida-area medical clinic owner pleaded guilty today for her role in a scheme to defraud Medicare by submitting fraudulent billings from the clinic and by supplying patients to three home health agencies that submitted fraudulent bills for home health services.
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 U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) and Special Agent in Charge Brian Swain of the U.S. Secret Service’s (USSS) Miami Field Office made the announcement.
Juliette Anais Tamayo, 53, of Miami, pleaded guilty to count two of a superseding indictment charging her with conspiracy to commit health care fraud and wire fraud. Tamayo previously pleaded guilty to count one of the superseding indictment, charging a conspiracy to pay and receive kickbacks and to defraud the United States. Her sentencing has been scheduled for April 30, 2019 by U.S. District Judge Cecelia Altonaga of the Southern District of Florida, who accepted both pleas.
Tamayo owned Sunshine Medical Care Group Inc. (Sunshine), a medical clinic in Miami. According to admissions made as part of her separate pleas to the health care fraud and kickback conspiracies, Tamayo solicited and accepted kickbacks from patient recruiters and from the owners of several Miami-area home health agencies in exchange for providing prescriptions for home health services to patients at Sunshine. The prescriptions, in turn, were used by the home health agencies to bill Medicare for home health services purportedly provided to Medicare beneficiaries. Tamayo paid a portion of the kickbacks she received from the home health agencies to physicians who worked at Sunshine to induce them to write the fraudulent prescriptions, she admitted.
The superseding indictment alleged that the losses to Medicare as a result of the scheme were approximately $3.7 million.
The principals of the home health agencies and one of the Sunshine physicians who wrote fraudulent prescriptions previously pleaded guilty to conspiracy to commit health care fraud in separate matters.
The case was investigated by the FBI, HHS-OIG and the U.S. Secret Service. Trial Attorneys Adam G. Yoffie and Gary A. Winters of the Criminal Division’s Fraud Section are prosecuting the case.
The Criminal Division’s Fraud Section leads the Medicare Fraud Strike Force. 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.