WASHINGTON – The owner and an employee
of a Miami home health care agency were sentenced today to 108 months and 46
months in prison, respectively, for their participation in a $22 million
Medicare fraud scheme, announced the Department of Justice, the FBI and the
Department of Health and Human Services (HHS).
U.S. District Judge Patricia A. Seitz in Miami
sentenced Marietha Morales, 38, to 108 months in prison and Eduardo
Saborit-Dominguez, 48, to 46 months in prison.
Both defendants were each sentenced to three years of supervised release. In addition, Morales was ordered to pay $14
million in restitution and Dominugez was ordered to pay $2 million in
restitution, jointly and severally with each other.
Last year, Morales pleaded guilty to one count
of conspiracy to commit health care fraud, and Dominguez pleaded guilty to one
count of conspiracy to defraud the United States and to receive and pay health
care kickbacks.
Morales was the president and Dominguez was an
employee of Prime Home Health Services Inc., a Florida home health agency that
purported to provide home health care and physical therapy services to eligible
Medicare beneficiaries.
According to plea documents, Morales
conspired with patient recruiters for the purpose of billing the Medicare
program for unnecessary home health care and therapy services. Morales and her co-conspirators paid
kickbacks and bribes to patient recruiters in return for the recruiters
providing patients to Prime Home Health, as well as prescriptions, plans of
care (POCs) and certifications for medically unnecessary therapy and home
health services for Medicare beneficiaries.
Dominguez distributed the kickbacks and bribes to co-conspirator patient
recruiters and knew that the payment of kickbacks and bribes was in violation
of federal criminal laws. Morales used
these prescriptions, POCs and medical certifications to fraudulently bill
Medicare for home health care services, which Morales knew was in violation of
federal criminal laws.
According to plea documents, nurses and office
staff at Prime Home Health falsified patient files for Medicare beneficiaries
to make it appear that such beneficiaries qualified for home health care and
therapy services. Morales admitted that
she knew the beneficiaries did not actually qualify for and did not receive
such services. Morales knew that these
files were falsified so that Medicare could be billed for medically unnecessary
therapy and home health related services.
From approximately February 2005 through
April 2011, Morales and her co-conspirators submitted approximately $22 million
in false and fraudulent claims to Medicare.
Medicare actually paid approximately $14 million on those claims.
The sentences were announced by Assistant
Attorney General Lanny A. Breuer of the Justice Department’s Criminal Division;
U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida; John V.
Gillies, Special Agent-in-Charge of the FBI’s Miami Field Office; and Special
Agent-in-Charge Christopher Dennis of the HHS Office of Inspector General
(HHS-OIG), Office of Investigations Miami Office.
This case is being prosecuted by Senior
Trial Attorney Joseph S. Beemsterboer of the Criminal Division’s Fraud
Section. The case was investigated by
the FBI and HHS-OIG, and was brought as part of the Medicare Fraud Strike
Force, supervised by the Criminal Division’s Fraud Section and the U.S.
Attorney’s Office for the Southern District of Florida.
Since their inception in March 2007, Medicare
Fraud Strike Force operations in nine locations have charged more than 1,330
defendants who collectively have falsely billed the Medicare program for more
than $4 billion. In addition, the HHS
Centers for Medicare and Medicaid Services, working in conjunction with the
HHS-OIG, are taking steps to increase accountability and decrease the presence
of fraudulent providers
To learn more about the Health Care
Fraud Prevention and Enforcement Action Team (HEAT), go to:
www.stopmedicarefraud.gov.
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