Owner of Michigan Home Health Agency Convicted in $1.6 Million Healthcare Fraud Scheme
A federal jury found a Detroit home health agency owner guilty today for her role in a scheme involving approximately $1.6 million in fraudulent Medicare claims for home health services that were procured through the payment of kickbacks, and that were medically unnecessary and not provided.
Acting Assistant Attorney General John P. Cronan of the Justice Department’s Criminal Division, Acting U.S. Attorney Daniel L. Lemisch of the Eastern District of Michigan, Special Agent in Charge David P. Gelios of the FBI’s Detroit Division and Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Chicago Regional Office made the announcement.
Editha Manzano, 69, of Troy, Michigan, was convicted of one count of conspiracy to commit health care and wire fraud, one count of conspiracy to pay and receive kickbacks in connection with Medicare beneficiaries, and one count of health care fraud following a seven-day trial. Sentencing has been scheduled for April 19, 2018, before U.S. District Judge Gershwin Drain of the Eastern District of Michigan, who presided over the trial.
According to evidence presented at trial, from 2013 to 2016, Manzano and her co-conspirators engaged in a scheme to defraud Medicare of approximately $1.6 million in fraudulent claims for home health care services in connection with Anointed Care Services, a Detroit area home health care agency (Anointed). The evidence showed that Manzano paid illegal kickbacks for patients to sign up for home health care with Anointed. The evidence further showed that Manzano conspired with physicians to admit patients for home health care with Anointed when they did not qualify for such services. To make it appear that these patients did qualify, Manzano and her co-conspirators falsified medical records and signed false documents purporting to show that patients admitted to Anointed’s home health program satisfied Medicare’s requirements for admission, the evidence showed.
Five defendants were charged in this matter. Liberty Jaramillo, 67, of Troy, Michigan, pleaded guilty in June 2017 and is awaiting sentencing. Dr. Roberto Quizon, 71, of Bloomfield Hills, Michigan, pleaded guilty in June of 2017 and is awaiting sentencing. In addition, Dr. Victoria Gallardo-Navarra, 74, of Bloomfield Hills, Michigan was acquitted after trial and Juan Yrorita, RN, 63, of Sterling Heights, Michigan, pleaded guilty during trial and is awaiting sentencing.
This case was investigated by the Office of Inspector General of the U.S. Department of Health and Human Services and the FBI. Trial Attorneys Jacob Foster and Rebecca Szucs of the Criminal Division’s Fraud Section are prosecuting the case.
The Fraud Section leads the Medicare Fraud Strike Force, which is part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. The Medicare Fraud Strike Force operates in nine locations nationwide. Since its inception in March 2007, the Medicare Fraud Strike Force has charged over 3,500 defendants who collectively have falsely billed the Medicare program for over $12.5 billion.