Tuesday, May 28, 2019

Owner of Miami Home Health Agency Sentenced to 30 Months in Prison for Role in Medicare Fraud Scheme


An owner of a now-defunct Miami, Florida, home health care agency was sentenced today to 30 months in prison for his participation in a scheme that caused Medicare to pay approximately $1 million in false and fraudulent claims for home health care services that were never provided.

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 and Special Agent in Charge George L. Piro of the FBI’s Miami Field Office made the announcement.

Dennys Hernandez, 47, of Riga, Michigan, was sentenced by U.S. District Judge Robert N. Scola of the Southern District of Florida.  Judge Scola also ordered Hernandez to pay $951,473 in restitution, jointly and severally with his co-conspirators, and to forfeit the same amount.  Hernandez pleaded guilty in March 2019 to one count of conspiracy to commit health care fraud and wire fraud.

According to admissions made as part of his plea agreement, Hernandez was an undisclosed co-owner of Medsel Home Health Care Corp. (Medsel), which purported to operate as a home health care agency.  Hernandez admitted that he and his co-conspirators used Medsel to fraudulently bill Medicare by submitting and causing the submission of claims for home health care services that were not provided to anyone.  As a result of his participation in the scheme and the submission of false and fraudulent claims, Medicare paid Medsel at least $950,000, Hernandez admitted. 

Two of Hernandez’s co-conspirators were charged in separate cases related to Medsel.  Elanier Gonzalez Moncho, 33, of Miami, the nominee owner of Medsel, was sentenced to 18 months in prison for his role in the fraud.  Rafael Arias, 54, of Miami, the owner and operator of numerous Miami-area home health agencies, including Medsel, was sentenced to 240 months in prison for his role in a $66 million conspiracy to defraud the Medicare program.

The FBI 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.  Trial Attorneys David Snider and Kevin Lowell of the Fraud Section prosecuted the case.

The Criminal Division’s Fraud Section leads the Medicare Fraud Strike Force. Since its inception in March 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.

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