Two Women Plead Guilty to Orchestrating $20 Million Medicare Fraud Scheme at Seven Miami Area Home Health Agencies
Two Miami residents pleaded guilty today to fraud charges stemming from their roles in a $20 million home health care 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 Field Office, 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, and Special Agent in Charge Brian Swain of the U.S. Secret Service (USSS)’s Miami Field Office made the announcement.
Mildrey Gonzalez, 61, of Miami, pleaded guilty to one count of conspiracy to commit health care fraud and one count of health care fraud before U.S. District Judge Jose E. Martinez of the Southern District of Florida. Milka Alfaro, 40, also of Miami, pleaded guilty to one count of conspiracy to commit health care fraud and wire fraud before Judge Martinez. Sentencing for both defendants has been scheduled for May 11 before Judge Martinez.
As part of their guilty pleas, Gonzalez and Alfaro admitted that they were co-owners and operators of seven home health care agencies purported to do business in Miami-Dade County: Inar Home Care Service Corp., MA Home Health Inc., Golden Home Health Care Inc., Nova Home Health Care Inc., Finetech Home Health Inc., Homestead Home Health Care LLC and Metro Dade Home Health Inc. According to admissions made as part of their guilty pleas, Gonzalez and Alfaro recruited and paid nominees to falsely represent themselves as the owners of the home health care agencies, thereby concealing their ownership interests from Medicare and the general public. Gonzalez and Alfaro further admitted that they paid bribes and kickbacks to medical professionals, including doctors, in return for the provision of prescriptions for home health care services and referrals of Medicare beneficiaries to their home health care agencies; that they paid patient recruiters bribes and kickbacks in return for referrals of Medicare patients to the home health care agencies; and that in some cases, the Medicare beneficiaries did not need the home health care services for which Medicare paid.
Gonzalez and Alfaro admitted that as a result of the fraudulent scheme, Medicare paid approximately $20 million to the above-referenced home health care agencies.
Gonzalez and Alfaro were charged in a superseding indictment returned on July 20, 2016, along with Adriana Jalil, 66, of Miami, who served as a patient recruiter, and Luis Luzardo, 48, also of Miami, who utilized sham staffing companies to launder money. Jalil and Luzardo pleaded guilty and were sentenced by Judge Martinez earlier this year to 24 and 37 months in prison, respectively.
The USSS, FBI and HHS-OIG investigated the case, which was brought as part of the Medicare Fraud Strike Force under the supervision of the Criminal Division’s Fraud Section and U.S. Attorney’s Office for the Southern District of Florida. Fraud Section Trial Attorney L. Rush Atkinson, former Fraud Section Attorney, current Assistant U.S. Attorney Lisa H. Miller and Assistant U.S. Attorneys Evelyn B. Sheehan and Alison W. Lehr of the Southern District of Florida are prosecuting the case.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged nearly 3,000 defendants who have collectively billed the Medicare program for more than $11 billion. In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.