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Guilty Plea in $25 Million Medicare Fraud Scheme
A patient recruiter has pleaded guilty in a $25 million Medicare fraud scheme. Beatriz Torres-Cruz, 50, pleaded guilty before U.S. District Judge Joan A. Lenard in Miami to one count of conspiracy to commit health care fraud and one count of solicitation of health care kickbacks.
Torres-Cruz was charged in a February 2011 indictment. According to plea documents, she was a patient recruiter for Florida Home Health Providers Inc., a Miami home health care agency that purported to provide home health and physical therapy services to Medicare beneficiaries.
The agency billed the Medicare program for expensive physical therapy and home health care services that were medically unnecessary and/or never provided. Court documents allege that the medically unnecessary services were prescribed by doctors, including Jose Nunez, M.D.
Torres-Cruz admitted that she offered and paid kickbacks and bribes to Medicare beneficiaries in return for those beneficiaries allowing Florida Home Health to bill Medicare for services that were medically unnecessary and/or never provided. She solicited and received kickbacks and bribes from the owners and operators of Florida Home Health in return for her patient recruiting.
As a result of Torres-Cruz’s participation in the illegal scheme, Medicare was billed approximately $195,000 for purported home health care services that were not medically necessary and/or were not rendered. Seventeen other co-conspirators have pleaded guilty for their roles in the fraud scheme, including Dr. Nunez.
Torres-Cruz faces a maximum prison sentence of 10 years for conspiracy to commit health care fraud and a maximum prison sentence of five years for solicitation of health care kickbacks. She also faces fines and terms of supervised release, as well as forfeiture of any property or proceeds derived from her criminal activities.
Sentencing has been scheduled for Jan. 30, 2012.
Assistant Attorney General Lanny A. Breuer of the Criminal Division; U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida; John V. Gillies, Special Agent-in-Charge of the FBI’s Miami field office; and Special Agent-in-Charge Christopher Dennis of the HHS Office of Inspector General (HHS-OIG), Office of Investigations Miami office announced the charges.
This case is being prosecuted by Trial Attorneys Joseph S. Beemsterboer and Jonathan Baum of the Criminal Division’s Fraud Section. The case was investigated by the FBI and HHS-OIG, and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Miami.
Since their inception in March 2007, Medicare Fraud Strike Force operations in nine locations have charged more than 1,140 defendants who collectively have falsely billed the Medicare program for more than $2.9 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 Action Team (HEAT), go to: www.stopmedicarefraud.gov.
Key Facts
- State: Federal
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
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