By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
A Miami patient recruiter will spend the next 37 months in prison for his part in a $20 million Medicare fraud scheme, according to the Department of Justice (DOJ). Manuel Lozano was sentenced on May 6, 2013, in the Southern District of Florida. In addition to his prison sentence, Mr. Lozano will serve two years of supervised release and was ordered to pay more than $1,850,000 in restitution, jointly with his co-conspirators. This story helps to prove what I’ve always said: “Florida is number one in health care fraud.”
To read the press release from the DOJ, click here.
Patient Recruiter Allegedly Received Illegal Kickbacks.
Mr. Lozano was a patient recruiter at a Miami home health care agency that allegedly provided home health and therapy services to Medicare beneficiaries. According to the DOJ, from April 2007 to March 2009, Mr. Lozano recruited patients for the home health company, and in doing so he received kickbacks and bribes from the owners and operators. The home health care company allegedly submitted around $20 million in Medicare claims that were either medically unnecessary or never rendered.
Home Health Company Owner and Operator Previously Sentenced.
The owner and the operator of the home health care company were sentenced on June 21, 2012, to more than six years in prison and ordered to pay $14 million in restitution.
Several other co-defendants pleaded guilty in March 2012, to one count of conspiracy to commit health care fraud.
Click here to read the press release.
What You Need to Know about Medicare and Medicaid Audits. I previously wrote a two-part blog on the increased number of Medicare and Medicaid audits being initiated against health professionals who treat home health care, assisted living facility (ALF) and SNF residents. This area of medical practice has been identified as one fraught with fraud and abuse. To learn more on the areas being targeted and how to respond to different types of audits, click here for the first blog, and click here for the second.
Don't Wait Until It's Too Late; Consult with a Health Law Attorney Experienced in Medicare and Medicaid Issues Now.
The attorneys of The Health Law Firm represent healthcare providers in Medicare audits, ZPIC audits and RAC audits throughout Florida and across the U.S. They also represent physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals and other healthcare providers and institutions in Medicare and Medicaid investigations, audits, recovery actions and termination from the Medicare or Medicaid Program.
For more information please visit our website at www.TheHealthLawFirm.com or call (407) 331-6620 or (850) 439-1001.
What do you think of this patient recruiter’s sentence? Please leave any thoughtful comments below.
Department of Justice. “Patient Recruiter of Miami Home Health Company Sentenced to 37 Months in Prison for Role in $20 Million Health Care Fraud Scheme.” Department of Justice. (May 6, 2013). From: http://www.justice.gov/opa/pr/2013/May/13-crm-510.html
Department of Justice. “Two Owners of Miami Home Health Company Each Sentenced to More Than Six Years in Prison for $20 Million Health Care Fraud Scheme.” Department of Justice. (June 21, 2012). From: http://www.justice.gov/opa/pr/2012/June/12-crm-790.html
About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.
Tag Words: Medicare, Medicare fraud, Medicare fraud scheme, Medicare audit, false claims, Department of Justice (DOJ), health care fraud, health care fraud scheme, patient recruiter, home health care company, kickbacks, Medicare beneficiaries, services not rendered, health care kickbacks, defense attorney, defense lawyer, Florida health care attorney, Florida health care lawyer, The Health Law Firm, health law
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