Henry Lora, Medicare Fraud, Florida 2016

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Miami Physician Gets 108 Months for $30 Million Medicare Fraud Scheme

A Miami physician, Henry Lora, 51, has been sentenced to 108 months in prison for his role in a Medicare fraud scheme that caused approximately $30 million in losses.

Lora pleaded guilty in February 2016 to one count of conspiracy to commit health care fraud and one count of conspiracy to defraud the United States, receive health care kickbacks and make false statements relating to health care matters. He was sentenced by U.S. District Judge Federico A. Moreno of the Southern District of Florida.

According to his plea agreement, Lora was the medical director of Merfi Corporation, a Miami-area clinic that employed physicians, physician assistants and other medical professionals. In exchange for kickbacks and bribes, Lora and his co-conspirators wrote prescriptions for home health care and other services for Medicare beneficiaries that were not medically necessary or not provided.

Lora and his co-conspirators also falsified patient records to make it appear as if the beneficiaries qualified for these services, he admitted. This caused multiple Miami-Dade home health care agencies and other providers to bill Medicare for services that were not medically necessary or not provided, resulting in Medicare making payments on these fraudulent claims.

Lora was ordered to pay $30,278,542 in restitution and to forfeit the same amount. In a related case, Isabel Medina, the owner of Merfi, who was charged separately, was sentenced to nine years in prison for conspiracy to commit health care fraud in March 2014.

The case 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, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida.

Since its inception in March 2007, the Medicare Fraud Strike Force has charged over 2,300 defendants who collectively have billed the Medicare program for over $7 billion. To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), visit www.stopmedicarefraud.gov.