Health Care Solutions Network Employee Sentenced in $63 Million Miami Medicare Fraud By Tod Aronovitz | 09/04/13 | 0 Comment

Lisset Palmero, a former receptionist and office manager at the now defunct Health Care Solutions Network, Inc.(HCSN), was sentenced to serve 68 months in prison for playing a key role in a Miami Medicare fraud scheme that resulted in more than $63 million in false claims to Medicare and Florida Medicaid from 2004 through 2011.

U.S. District Judge Cecilia M. Altonaga also sentenced Palmero to three years of supervised release and ordered her to pay $17.4 million in restitution.

According to prosecutors, the 45-year old Palmero knew that the mental health centers in Florida were paying illegal kickbacks to owners and operators of Miami-Dade Assisted Living Facilities (ALF) in exchange for patient referral information that was used to submit the fraudulent claims. In addition, Palmero was aware that many of the ALF referral patients were ineligible for Partial Hospitalization Program (PHP) services because they suffered from mental retardation, dementia or Alzheimer’s disease.

Court documents revealed that even though Palmero knew employees fabricated medical records weeks or months after patients were admitted to HCSN-FL for purported PHP treatment, or had made up “ghost patients” who were never admitted to HCSN-FL, she actively concealed the fabricated medical records. In her employment as office manager, she prepared—or had others prepare—documentation that was used to support the false and fraudulent billing to the government.

Palmero, who pled guilty in May, was the last of 13 defendants in the initial string of arrests related to the HCSN scheme. Federal investigators arrested seven more in July in connection with the case.

How to Report Miami Medicare Fraud
Healthcare or medical billing employees who have inside knowledge of questionable Medicare billing practices can file a confidential legal claim under the False Claims Act. By acting as a “whistleblower” in what is known as a “qui tam” lawsuit, a private party may collect between 10 to 30 percent of the amount recovered, depending on how the case is prosecuted.

ARONOVITZ LAW: Miami Whistleblower / Qui Tam Law Firm

The Miami Qui Tam law firm of ARONOVITZ LAW routinely works with Miami whistleblowers to document Medicare fraud and other forms of fraud against the government. Contact Miami Whistleblower / Qui Tam lawyer Tod Aronovitz to discuss a case.