Yunesky I. Fornaris, $15M Medicare Fraud, Florida 2016

South Florida home health care owner Yunesky I. Fornaris, 38, of Miami, was charged in a $15 million Medicare fraud scheme involving fraudulent claims for home health services, authorities announced today.

Acting Assistant Attorney General Kenneth A. Blanco, Acting U.S. Attorney Benjamin G. Greenberg of the Southern District of Florida, Special Agent in Charge George L. Piro of the FBI’s Miami Field Office, Special Agent in Charge Shimon R. Richmond of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Miami Regional Office, and Special Agent-in-Charge Brian Swain of the U.S. Secret Service’s (USSS) Miami Field Office made the announcement.

Fornaris was charged with one count of conspiracy to commit health care fraud and wire fraud, two counts of health care fraud, and one count of conspiracy to defraud the United States and pay health care kickbacks. He was arrested today and made his initial appearance before U.S. Magistrate Judge William C. Turnoff of the Southern District of Florida.

The indictment alleges that from in or around April 2010 through July 2016, Fornaris and his co-conspirators hid their ownership in Elite Home Care LLC (Elite), a Miami-area home health clinic, in the name of a nominee owner in an effort to conceal their participation in the fraudulent scheme. According to the indictment, Fornaris and his co-conspirators allegedly submitted false and fraudulent application documents, causing Medicare to give and continue to reauthorize Elite’s Medicare provider number.

As a result, the number enabled Fornaris and his co-conspirators to allegedly submit fraudulent claims for services that were not medically necessary or never provided. In addition, Fornaris allegedly signed portions of Elite’s Medicare applications and re-certifications committing Elite to comply with Medicare’s rules and regulations, as well as the Federal Anti-Kickback Statute. Notwithstanding these certifications, Fornaris and his co-conspirators allegedly caused kickbacks to be paid to Medicare beneficiaries and patient recruiters in exchange for the referral of Medicare beneficiaries to Elite.

According to the indictment, Medicare paid approximately $15 million as a result of false and fraudulent claims submitted by Elite. An indictment is merely an allegation and the defendant is presumed innocent unless and until proven guilty beyond a reasonable doubt in a court of law.

The FBI, HHS-OIG, and USSS investigated the case, which 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 of the Southern District of Florida. Former Fraud Section Attorney Lisa H. Miller and current Fraud Section Attorney Adam G. Yoffie are prosecuting the case.

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