Doral Woman Convicted of Health Care Fraud and False Statements Regarding Health Care Matters

Wifredo A. Ferrer, United States Attorney for the Southern District of Florida; John V. Gillies, Special Agent in Charge, Federal Bureau of Investigation, Miami Field Office; and Christopher B. Dennis, Special Agent in Charge, U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), Office of Investigations, Miami Regional Office, announced that a federal jury in Miami found Isachi Gil, 36, of Doral, Florida, guilty of health care fraud and making false statements related to health care matters. More specifically, after a three week trial, the jury convicted Gil of five counts of health care fraud, in violation of Title 18, United States Code, Section 1347, and six counts of false statements related to health care matters, in violation of Title 18, United States Code, Section 1035.

Sentencing is scheduled for July 27, 2011 before U.S. District Judge Marcia Cooke. Gil faces a statutory maximum of 10 years’ imprisonment as to each of the fraud charges, and five year imprisonment as to each of the false statement charges.

According to the evidence presented at trial, Gil was a registered nurse employed by 13 separate Miami-Dade based home health care agencies. As part of her job as a home health nurse, Gil provided skilled nursing services to Medicare beneficiaries that were homebound, diabetic, insulin-dependent, and so ill that they were unable to inject themselves with insulin. Under Medicare regulations, Gil was required to keep records of each time she provided a skilled nursing service to a Medicare beneficiary. Between March 2007 and July 2009, Gil completed hundreds of documents in which she claimed that she had injected Medicare beneficiaries with insulin two times a day, seven days per week.

At trial, however, the evidence showed that at least two of the Medicare beneficiaries that the defendant claimed to be injecting with insulin were not diabetic. In addition, the evidence showed more than 160 instances in which the defendant was out of the country, including being in Panama, Mexico, or the Dominican Republic, during the dates that she claimed to be providing skilled nursing services to Medicare beneficiaries. As well, the defendant signed dozens of documents claiming that she was providing skilled nursing services when, in fact, she was attending classes at Florida International University. Also, the defendant claimed to be providing skilled nursing visits to two and three patients simultaneously, double and triple billing Medicare. The defendant’s false statements resulted in the submission of hundreds of thousands of dollars in false claims to Medicare for services that were either not medically necessary or provided to Medicare beneficiaries.

Mr. Ferrer commended the investigative efforts of the FBI and HHS-OIG. This case was prosecuted by Assistant U.S. Attorneys Daniel Bernstein and Robert J. Luck.

A copy of this press release may be found on the website of the United States Attorney’s Office for the Southern District of Florida at www.usdoj.gov/usao/fls. Related court documents and information may be found on the website of the United States District Court for the Southern District of Florida at www.flsd.uscourts.gov or http://pacer.flsd.uscourts.gov.