Adelma Casas Sevilla, Medicare Fraud, Texas 2011
HOUSTON, TEXAS - In a shocking revelation, a Houston registered nurse has pleaded guilty to her involvement in a massive $5.2 million Medicare fraud scheme. Adelma Casas Sevilla, 54, was found to have been working with a home health care company, Family Healthcare Group, to defraud the Medicare program.
According to court documents, Sevilla fraudulently signed plans of care for Medicare beneficiaries stating they needed home health care when, in fact, she knew they were not in need of skilled nursing. This was done in exchange for recruiting Medicare beneficiaries to file claims with Medicare for medically unnecessary and/or not provided skilled nursing.
The scheme, which was uncovered by the Medicare Fraud Strike Force, has resulted in a significant blow to the integrity of the Medicare program. The strike force, which is a joint effort between the U.S. Attorney's Office and the Criminal Division's Fraud Section, has been instrumental in uncovering and prosecuting Medicare fraud cases across the country.
Sevilla's guilty plea is a major victory for the government in its efforts to combat Medicare fraud. Her sentencing is scheduled for July 21, 2011, where she faces a maximum sentence of 10 years in prison for the health care fraud conspiracy count.
The case against Sevilla is part of a larger effort to root out Medicare fraud and abuse. Since its inception in March 2007, the Medicare Fraud Strike Force has charged over 1,000 defendants who have collectively falsely billed the Medicare program for over $2.3 billion.
Sevilla's actions are a stark reminder of the need for increased vigilance in preventing and detecting Medicare fraud. The Health Care Fraud Prevention and Enforcement Action Team (HEAT) is working closely with the HHS's Centers for Medicare and Medicaid Services and the HHS-OIG to increase accountability and decrease the presence of fraudulent providers.
As the investigation continues, it is clear that Sevilla's actions will have far-reaching consequences for the individuals involved and the Medicare program as a whole.
Defendant: Adelma Casas Sevilla
Criminal Charge: Conspiracy to Commit Healthcare Fraud
City: Houston, Texas
State: Texas
Date: 2011
Sentence: Up to 10 years in prison
Amount: $5.2 million
Key Facts
- State: Federal
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
ðŸâ€Â’ Get the grimiest stories delivered weekly. Subscribe free →