Miami Doctor Gets Slapped With Nine Years in Prison for Complex $30 Million Medicare Fraud Scheme

Sunday, May 1, 2016
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On April 18, 2016, Dr. Henry Lora, a doctor in Miami was sentenced to nine years in federal prison for his role in a scheme to defraud the Medicare system out of around $30 million in phony reimbursements. Dr. Lora is the latest of five individuals sentenced in the South Florida fraud ring, according to the Department of Justice.

Dr. Lora was also ordered to pay $30.3 million in restitution, according to a statement from the DOJ. He was indicted in October 2015 and in February 2016, he pled guilty to one count of conspiracy to commit health care fraud and one count of conspiracy to defraud the United States. Click here to read more.


The Plea Agreement.


As part of his plea agreement, Lora who was the former medical director of the now-defunct Merfi Corp. admitted to writing prescriptions for Medicare beneficiaries that either weren’t needed or weren’t provided, in exchange for kickbacks and bribes from patient recruiters, home health care operators and other providers. Prosecutors said Dr. Lora also falsified patient records in order to make it seem as though they qualified for the services. To read Dr. Lora’s plea agreement, click here.


The Co-Conspirators.


Isabel Medina, Merfi’s owner, was also sentenced to nine years in prison after pleading guilty in January 2014 to conspiracy to commit health care fraud, in connection with multiple fraud schemes.

In addition, co-conspirators German Martinez, Lerida Labrada and Mayra Flores were sentenced to 24, 37 and 24 months in prison, respectively. The three worked as patient recruiters for the owners of Flores Home Health, according to the DOJ, and Labrada also owned and operated a medical clinic that provided fraudulent prescriptions to patient recruiters and to Flores Home Health.

Click here to read further on the co-conspirators.

Click here to read one of my prior blogs on another case of Medicare Fraud in Florida.


Health Care Fraud Should Not Be Taken Lightly.


We have been consulted by many individuals, both before and after criminal convictions for fraud or related offenses.  In many cases, those subject to Medicare fraud audits and investigations refuse to acknowledge the seriousness of the matter.  Some may even decide not to spend the money required for a highly experienced health attorney to defend them.

Click here to read one of my previous blog posts regarding Medicare audits.

The government is serious about combating health care fraud.  It created a Medicare Fraud Strike Force in March of 2007, in an effort to further prevent and eliminate fraud and abuse of government health care programs.  False claims are a growing problem in the program, costing the government billions of dollars each year.  Accordingly, punishments for defrauding the system can be quite severe.  

If you are accused of Medicare fraud, realize that you are in a fight for your life.  Your liberty, property/possessions and profession are all at stake.  Often it is possible to settle allegations of Medicare fraud by agreeing to pay civil monetary penalties and fines.  If given such an opportunity, the Medicare provider should consider whether it is worth the risk of facing decades in prison.  Be prepared to give up whatever you need to in order to avoid a conviction and preserve your liberty.


Don’t Wait Until It’s Too Late; Consult with a Health Law Attorney Experienced in Medicare 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.


Sources:


Kass, Dani. “Miami doc gets 9 years for Medicare fraud scheme.” Law360. (April 18, 2016). Web.

“Miami Doctor Gets 9 Years in Prison in $30 Million Medicare Fraud Scheme.” NBC Miami. (April 18, 2016). Web.


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.


Keywords:  Medicare audit defense, Medicare billing, health care clinic fraud audit, Medicare fraud defense attorney, defense lawyer, Florida health attorney, Florida health lawyer, health care fraud, health care fraud scheme, health law, insurance fraud, Medicare fraud scheme, The Health Law Firm, Medicare fraud defense lawyer, Medicare investigation, defense counsel, co-conspirator in Medicare fraud scheme, health law criminal defense, health law criminal representation, restitution for health care fraud offense, Medicare reimbursement claims, improper Medicare billing claims, false claims defense attorney

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 2016 The Health Law Firm. All rights reserved.

5/1/2016

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