WASHINGTON – A Miami home health agency owner was sentenced to 120 months in prison for his role in a $42 million Medicare fraud scheme, announced federal officials.
Eulises Escalona, 44, of Monroe County, Fla., was sentenced by U.S. District Judge Joan A. Lenard in the Southern District of Florida. In addition to the prison term, Judge Lenard ordered Escalona to pay $26.5 million in restitution.
Escalona pleaded guilty on Aug. 2, 2012, to one count of conspiracy to commit health care fraud. As the owner of Willsand Home Health Inc., Escalona conspired with patient recruiters to bill Medicare for unnecessary home health care and therapy services.
Escalona and his co-conspirators paid kickbacks and bribes to patient recruiters and physicians in exchange for patients, prescriptions, and medical certifications for medically unnecessary therapy and home health services. The Medicare program paid out approximately $27 million on the false claims submitted by Escalona and his co-conspirators.
The scheme, which lasted from January 2006 to November 2009, involved the submission of approximately $42 million in false and fraudulent claims to Medicare. The case was investigated by the FBI and HHS-OIG and brought as part of the Medicare Fraud Strike Force.
Since its inception in March 2007, the Medicare Fraud Strike Force has charged over 1,480 defendants who have collectively billed the Medicare program for more than $4.8 billion. The Health Care Fraud Prevention and Enforcement Action Team (HEAT) is working to increase accountability and decrease the presence of fraudulent providers.
The case is being prosecuted by Senior Trial Attorney Joseph S. Beemsterboer of the Criminal Division’s Fraud Section. The investigation was led by the FBI and HHS-OIG, with assistance from the U.S. Attorney’s Office for the Southern District of Florida.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), visit www.stopmedicarefraud.gov.
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