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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