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Manager of Miami Health Care Agency and Registered Nurse Plead Guilty in $25 Million Health Care Fraud Scheme
Washington – Lisandra Alonso, 33, and Luisa Morciego, 39, each pleaded guilty before U.S. District Judge Joan A. Lenard in Miami to one count of conspiracy to commit health care fraud.
Alonso and Morciego were charged in a February 2011 indictment. According to plea documents, Alonso was a manager and patient recruiter for ABC Home Health Care. Morciego was a registered nurse and worked for ABC and Florida Home Health Care Providers Inc.
ABC and Florida Home Health were Miami home health care agencies that purported to provide home health and physical therapy services to Medicare beneficiaries. According to court documents, ABC and Florida Home Health were operated for the purpose of billing the Medicare program for expensive physical therapy and home health care services that were medically unnecessary and/or were never provided.
Court documents allege that the medically unnecessary services were prescribed by doctors, including Jose Nunez, M.D., and Francisco Gonzalez, M.D. Nunez and Gonzalez were also charged in the February 2011 indictment along with Alonso, Morciego and 17 other co-conspirators.
According to court documents, beginning in approximately January 2006 and continuing until approximately March 2009, Alonso taught the owners and operators of ABC how to operate a fraudulent home health agency. Alonso explained the structure of the corrupt scheme, specifically the importance of recruiters, kickbacks, doctors, beneficiaries and Medicare billing.
Alonso negotiated kickback payment rates between patient recruiters and the ABC owners and operators, and distributed the kickback payments to patient recruiters on behalf of the ABC owners and operators. Alonso also served as a patient recruiter for ABC. She paid kickbacks and bribes to beneficiaries in return for those beneficiaries allowing ABC to bill Medicare for services that were medically unnecessary and/or never provided.
Alonso also taught nurses at ABC how to falsify patient files for Medicare beneficiaries to make it appear that such beneficiaries qualified for home health care and therapy services from ABC. Alonso taught the nurses to do so by, among other things, describing in the nursing notes and patient files non-existent symptoms such as tremors, impaired vision, weak grip and inability to walk without assistance. These symptoms were described to make it appear that the patients qualified for home health care benefits under Medicare.
As a result of Alonso’s participation in the illegal scheme, the Medicare program was billed approximately $17 million for home health care services that were medically unnecessary and/or were never provided.
Luisa Morciego worked as a registered nurse for ABC and Florida Home Health. During that time, Morciego falsified patient files for Medicare beneficiaries to make it appear that the beneficiaries qualified for home health care and therapy services. Morciego knew that the beneficiaries did not actually qualify for and did not receive the services.
As a result of Morciego’s participation in the illegal scheme, ABC and Florida Home Health were able to bill the Medicare program for medically unnecessary services.
Key Facts
- State: Federal
- Category: White Collar Crime
- Source: DOJ Press Release â†â€â€
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