Ivan Alejo, Health Care Fraud, Florida 2013

A patient recruiter and a therapy staffing company owner were sentenced to serve time in prison for their participation in a $7 million health care fraud scheme involving defunct home health care company Anna Nursing Services Corp.

Ivan Alejo, 48, and Hugo Morales, 37, both of Miami, were sentenced by U.S. District Judge Jose E. Martinez in the Southern District of Florida. Alejo was sentenced to serve 50 months in prison, while Morales was sentenced to 46 months.

In addition to their prison terms, Alejo and Morales were both sentenced to serve three years of supervised release. Alejo and Morales were also ordered to pay jointly and severally with their co-defendants $6,928,931 and $1,958,279, respectively, in restitution.

Alejo worked as a patient recruiter at Anna Nursing, a Miami home health care agency that purported to provide home health and therapy services to Medicare beneficiaries. Morales owned a therapy staffing company, Professionals Therapy Staffing Services Inc., which provided therapists to Anna Nursing.

According to court documents, co-conspirators of Alejo and Morales operated Anna Nursing for the purpose of billing the Medicare Program for, among other things, expensive physical therapy and home health care services that were not medically necessary and/or not provided.

The case against Alejo and Morales was investigated by the FBI and the U.S. Department of Health and Human Services Office of Inspector General, and was brought as part of the Medicare Fraud Strike Force. Alejo and Morales pleaded guilty to conspiracy to commit health care fraud in August 2013.

Alejo’s primary role in the scheme at Anna Nursing involved negotiating and paying kickbacks and bribes, interacting with patient recruiters and assisting in the submission of fraudulent claims to the Medicare program. Morales’s primary role in the scheme at Anna Nursing involved operating Professionals Therapy, where he and others created fictitious progress notes and other patient files indicating that therapists from Professionals Therapy had provided physical or occupational therapy services to particular Medicare beneficiaries.

From approximately October 2010 through approximately April 2013, Anna Nursing was paid by Medicare approximately $7 million for fraudulent claims for home health care services that were not medically necessary and/or not provided.

Alejo and Morales were ordered to pay jointly and severally with their co-defendants $6,928,931 and $1,958,279, respectively, in restitution.

The case was prosecuted by Trial Attorney A. Brendan Stewart of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida.

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