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Miami Home Health Owner Sentenced to 80 Months for $74 Million Medicare Scheme
Elsa Ruiz, a 45-year-old Miami woman, was sentenced to 80 months in prison for her role in a $74 million Medicare fraud scheme. Ruiz, the owner and administrator of two Miami home health care companies, pleaded guilty in July 2014 to one count of conspiracy to commit health care fraud.
According to her admissions during the plea hearing, Ruiz and her co-conspirators operated the companies, Professional Home Care Solutions Inc. and LTC Professional Consultants Inc., to bill the Medicare program for expensive physical therapy and home health care services that were not medically necessary or were not provided.
Ruiz’s primary role in the scheme was to negotiate and pay kickbacks to patient recruiters and to oversee the schemes operating out of the two companies. She and her co-conspirators paid kickbacks to patient recruiters for the referral of patients and for the provision of prescriptions, plans of care, and certifications for medically unnecessary therapy and home health services.
The scheme resulted in approximately $74 million in claims being submitted to Medicare, with the program paying out around $45 million on those claims. Ruiz was also ordered to pay $45 million in restitution as part of her sentence.
The case was investigated by the HHS Office of Inspector General and the FBI, and was brought as part of the Medicare Fraud Strike Force. The strike force has charged nearly 2,000 defendants who have collectively billed the Medicare program for over $6 billion since its inception in March 2007.
Assistant Attorney General Leslie R. Caldwell, U.S. Attorney Wifredo A. Ferrer, Special Agent in Charge George L. Piro, and Special Agent in Charge Derrick Jackson made the announcement. U.S. District Judge Marcia G. Cooke imposed the sentence.
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Key Facts
- State: Florida
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release ↗
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