Ten Assisted Living Facility Owners Indicted for Receipt of Health Care Kickbacks and Health Care Fraud
Ten owners of Miami-Dade assisted living facilities have been charged with participating in a health care fraud scheme and for receiving kickbacks, in violation of Title 18, United Sates Code, Section 1347 and Title 42, United States Code, Section 1320.
Wifredo A. Ferrer, United States Attorney for the Southern District of Florida, Pam Bondi, Florida Attorney General, Shimon R. Richmond, Special Agent in Charge, U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), and George L. Piro, Special Agent in Charge, Federal Bureau of Investigation (FBI), Miami Field Office, made the announcement.
Marlene Marrero, 60, of Miami, Blanca Orozco, 69, of Miramar, Norma Casanova, 67, of Miami Lakes, Yeny De Erbiti, 51, of Miami, Rene Vega, 57, of Miami, Maribel Galvan, 43, of Miami Lakes, Dianelys Perez, 34, of Miami Gardens, Osniel Vera, 47, of Hialeah, Alicia Almeida, 56, of Miami Lakes, and Jorge Rodriguez, 57, of Hialeah, are charged in a 30-count indictment for receiving cash kickbacks and bribes in return for referring individuals residing in their assisted living facilities to the former owner of Florida Pharmacy Inc., a Miami-Dade company, for prescription medications and durable medical equipment paid for by Medicare and Florida Medicaid.
The indictment also charges these ten individuals with health care fraud for allegedly participating in a scheme where they signed and submitted Non-Institutional Medicaid Provider Agreements wherein they falsely represented to Medicaid that they would comply with state and federal laws and all agency rules contained in the Florida Medicaid Provider Handbook which prohibits the solicitation and receipt of kickbacks. As a result of the defendants’ submission of these false and fraudulent documents Medicaid renewed their provider numbers which allowed them to continue to submit claims for services purportedly rendered to eligible Medicaid beneficiaries. The defendants caused their assisted living facilities to submit false claims to Medicaid. As a result of these false and fraudulent claims, Medicaid made payments to the assisted living facilities owned and operated by the defendants.
“The U.S. Attorney’s Office and our law enforcement partners remain committed to prosecuting members of the South Florida assisted living community who fraudulently use the Medicare and Medicaid benefits of their residents to obtain illegal bribes and kickbacks,” stated U.S. Attorney Wifredo Ferrer.
Attorney General Pam Bondi stated, “We will not allow anyone to take advantage of seniors to defraud the Medicaid program. Thanks to the joint investigative efforts of my Medicaid Fraud Control Unit and our federal partners, this scheme has been stopped and those responsible will be held accountable.”
“No matter what the scheme or how elaborately disguised, the FBI and our law enforcement partners will investigate and prosecute Medicare fraud to the fullest extent of the law,” said George L. Piro, Special Agent in Charge, FBI Miami.
The case is being investigated by the FBI, HHS-OIG, and the State of Florida’s Medicaid Fraud Control Unit and was brought as part of the Medicare Fraud Strike Force, under the supervision of U.S. Attorney’s Office for the Southern District of Florida. The case is being prosecuted by Special Assistant United States Attorney Hagerenesh Simmons.
Since their inception in March 2007, Medicare Fraud Strike Force operations in nine cities have charged more than 2,180 defendants who collectively have falsely billed the Medicare program for more than $6.5 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.
An indictment is only an accusation and a defendant is presumed innocent unless and until proven guilty.