Former Operator Of Rehabilitation Therapy Clinic Pleads Guilty For Role In Medicare Fraud Scheme

WASHINGTON – A south Florida woman who had been the president of CORF National Development Inc. has pleaded guilty for her involvement in a Medicare fraud scheme involving physical and occupational therapy services.

Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division, Acting U.S. Attorney A. Lee Bentley III of the Middle District of Florida, Special Agent in Charge Paul Wysopal of the FBI’s Tampa Field Office, and Special Agent in Charge Christopher Dennis of the U.S. Health and Human Services Office of Inspector General (HHS-OIG) made the announcement.

Milagros Cruz, 42, pleaded guilty in the U.S. District Court for the Middle District of Florida to conspiring to commit health care fraud.  She faces a maximum penalty of 10 years in prison when she is sentenced. 

According to court documents, Cruz conspired with others to execute a health care fraud scheme involving the submission of claims for reimbursement to Medicare for rehabilitation therapy services that were not legitimately prescribed by physicians and not legitimately provided to Medicare beneficiaries.  Cruz, as president of CORF National Development, located in Doral, Fla., paid cash kickbacks to Medicare beneficiaries who came to CORF National Development in exchange for using the beneficiaries’ identifying information in the fraud scheme.  Cruz would combine the Medicare beneficiaries’ identifying information with other billing information and provide the information to other conspirators.  These conspirators then converted the information into reimbursement claims submitted to Medicare in the name of a completely different clinic known as Renew Therapy Centers of Port St. Lucie LLC.  From January through August 2008, Cruz’s clinic received approximately $90,950 from Renew Therapy in connection with the fraud scheme.

This case is being investigated by the FBI and 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 Middle District of Florida.  This case is being prosecuted by Trial Attorney Christopher J. Hunter 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 more than 1,700 defendants who have collectively billed the Medicare program for more than $5.5 billion.  In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

To learn more about the Health Care Fraud Prevention and Enforcement Team (HEAT), go to: www.stopmedicarefraud.gov.