Owner of Miami Home Health Care Company Sentenced to 10 Years in Prison for Lead Role in $13 Million Medicare Fraud Scheme
An owner of a Miami home health care company was sentenced today to 10 years in prison for his leading role in a $13 million Medicare fraud scheme that involved paying kickbacks and bribes to patient recruiters, Medicare beneficiaries and others in South Florida doctors’ offices and medical clinics.
Assistant Attorney General Leslie R. Caldwell 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 Field Office and Special Agent in Charge Shimon R. Richmond of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Miami Regional Office made the announcement.
Alexander Lara, 46, of Hollywood, Florida, pleaded guilty before U.S. Magistrate Judge Chris M. McAliley of the Southern District of Florida on Feb. 17, 2015, to one count of conspiracy to commit health care fraud. According to admissions made as part of his guilty plea, Lara was an owner and operator of Longcare Home Health Corporation (Longcare Home Health), a Miami home health care agency that purported to provide home health and therapy services to Medicare beneficiaries, but the company fraudulently billed the Medicare program for, among other things, expensive physical therapy and home health care services that were not medically necessary or not provided at all. From approximately January 2009 through November 2014, Medicare paid approximately $13.7 million for fraudulent claims submitted by Longcare Home Health, according to court documents.
Lara admitted that he personally paid kickbacks and bribes to patient recruiters and to Medicare beneficiaries in exchange for referrals. He also admitted to paying kickbacks and bribes in doctors’ offices and clinics in exchange for fraudulent home health prescriptions for medically unnecessary therapy and services. These prescriptions and recruited patients were used to fraudulently bill the Medicare program for home health care services.
In addition to his sentence, Lara was ordered to pay $13,771,528.94 in restitution and to forfeit $13,771,528.94, which represents the proceeds traceable to his criminal conduct at Longcare Home Health. Lara was sentenced by Chief U.S. District Judge K. Michael Moore of the Southern District of Florida.
The case was investigated by the FBI and HHS-OIG, and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office of the Southern District of Florida. The case was prosecuted by Trial Attorney Anne P. McNamara of the Criminal Division’s Fraud Section.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged nearly 2,100 defendants who have collectively billed the Medicare program for more than $6.5 billion. In addition, the HHS’s Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, is 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.