Miami Woman Sentenced to More Than Three Years in Prison for Role in $1.36 Million Medicare Fraud Scheme

A Miami, Florida woman was sentenced to 46 months in prison on Jan. 3 for her role in a $1.36 million health care fraud scheme.

Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Ariana Fajardo Orshan of the Southern District of Florida, Special Agent in Charge George L. Piro of the FBI’s Miami Field Office and 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 made the announcement.

Tania Gudin, 55, was sentenced by U.S. District Judge K. Michael Moore of the Southern District of Florida.  Judge Moore also ordered Gudin to pay $1,366,317.59 in restitution and to forfeit $512,806.05.  Gudin pleaded guilty on Oct. 23, 2018 to one count of conspiracy to commit health care fraud and wire fraud.

Gudin pleaded guilty to accepting kickbacks for recruiting and referring Medicare beneficiaries to five Miami-area businesses that claimed to provide home health care services: Maya Home Health Care Corp., Floridian Home Health Care Corp., Healthylife Home Care Inc., ACM Home Health Corp., and Humanity Home Health Inc.  She also owned her own medical clinic, the New City Medical Center Inc., which she admittedly utilized to further the scheme, including by obtaining prescriptions for her recruited patients from medical professionals at New City.     

As part of her guilty plea, Gudin admitted that from approximately July 2011 through approximately November 2014, she accepted kickbacks in return for the referral of Medicare beneficiaries, many of whom did not need or qualify for home health services, to serve as patients of the five agencies.  Gudin caused Maya, Floridian, Healthylife, ACM, and Humanity to submit false claims to Medicare for home health services for the beneficiaries she recruited, which were medically unnecessary, not eligible for Medicare reimbursement and/or – either with Gudin’s knowledge or direction – never actually provided.  

Gudin admitted that, as a result of false and fraudulent claims submitted as part of this conspiracy, Medicare made payments of at least $1.36 million.

The FBI and HHS-OIG 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 for the Southern District of Florida.  Former Fraud Section Trial Attorney and current Assistant U.S. Attorney Leslie Wright of the District of Boston prosecuted the case; the case is now being handled by Trial Attorney Emily Gurskis of the Fraud Section.

The Criminal Division’s Fraud Section leads the Medicare Fraud Strike Force.  Since its inception in 2007, the Medicare Fraud Strike Force, which maintains 14 strike forces operating in 23 districts, has charged nearly 4,000 defendants who have collectively billed the Medicare program for more than $14 billion.  In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.