Dennis Hernandez, Health Care Fraud, Florida 2008

A $6.2 million Medicare fraud scheme involving a Miami home health care agency has been exposed, with five South Florida residents pleading guilty to their roles in the scam.

The scheme, which involved Professional Medical Home Health LLC (Professional Home Health), a Miami home health care agency that purported to provide home health and therapy services, was uncovered by the FBI and the U.S. Department of Health and Human Services Office of Inspector General.

The five defendants, Dennis Hernandez, 32, of Miami, Juan Valdes, 37, of Palm Springs, Florida, Jose Alvarez, 48, and Joel San Pedro, 44, both of Miami, and Alina Hernandez, 38, of West Palm Beach, Florida, each pleaded guilty to one count of conspiracy to commit health care fraud.

According to their plea agreements, the defendants held positions of influence at Professional Home Health, including owner/operator and manager/supervisor. They admitted to billing the Medicare program for expensive physical therapy and home health services that were not medically necessary or were not provided.

The defendants also admitted to being patient recruiters for Professional Home Health, soliciting and receiving kickbacks and bribes from other co-conspirators in exchange for recruiting beneficiaries who neither needed, nor, in some cases, received services.

From December 2008 through February 2014, Medicare paid Professional Home Health more than $6.2 million for these fraudulent home health claims.

Earlier this year, two other individuals pleaded guilty and were sentenced in connection with the same scheme. Annarella Garcia, an owner of Professional Home Health, was sentenced to serve 70 months in prison. Annilet Dominguez, an administrator of Professional Home Health, was sentenced to serve 68 months in prison.

The case was 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 Southern District of Florida.

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