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Medicare Fraudster Pleads Guilty
A south Florida woman has been convicted of her role in a massive Medicare fraud scheme that netted her tens of thousands of dollars in ill-gotten gains.
Milagros Cruz, 42, pleaded guilty to conspiring to commit health care fraud in the U.S. District Court for the Middle District of Florida. She faces a maximum penalty of 10 years in prison when she is sentenced.
According to court documents, Cruz conspired with others to execute a health care fraud scheme involving the submission of claims for reimbursement to Medicare for rehabilitation therapy services that were not legitimately prescribed by physicians and not legitimately provided to Medicare beneficiaries.
Cruz, as president of CORF National Development, located in Doral, Fla., paid cash kickbacks to Medicare beneficiaries who came to CORF National Development in exchange for using the beneficiaries’ identifying information in the fraud scheme.
Cruz would combine the Medicare beneficiaries’ identifying information with other billing information and provide the information to other conspirators. These conspirators then converted the information into reimbursement claims submitted to Medicare in the name of a completely different clinic known as Renew Therapy Centers of Port St. Lucie LLC.
From January through August 2008, Cruz’s clinic received approximately $90,950 from Renew Therapy in connection with the fraud scheme.
The case is being 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 Middle District of Florida. This case is being prosecuted by Trial Attorney Christopher J. Hunter of the Criminal Division’s Fraud Section.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,700 defendants who have collectively billed the Medicare program for more than $5.5 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.
For more information on the Health Care Fraud Prevention and Enforcement Team (HEAT), visit www.stopmedicarefraud.gov.
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Key Facts
- State: Florida
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release ↗
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