Home Health Agency Owner Pleads Guilty in $74 Million Miami Medicare Fraud By Tod Aronovitz | 07/31/14 | 0 Comment

Elsa Ruiz, a Miami resident who did double-duty as the owner of one home health care company while an administrator at another, was recently connected to a $74 million Miami Medicare fraud scheme.

As a result of her role in the scheme, Ruiz pleaded guilty on July 23 to one count of conspiracy to commit health care fraud before U.S. District Judge Marcia G. Cooke in the Southern District of Florida, the Department of Justice announced.

Ruiz owned Professional Home Care Solutions and managed LTC Professional Consultants, a second home health care agency. Court documents show that Ruiz oversaw schemes operating out of both Miami-based companies, which were allegedly in business to illegally bill the Medicare program.

The scheme involved paying kickbacks and bribes to patient recruiters who not only provided patients to the two companies, but also supplied prescriptions, plans of care (POCs) and certifications for Medicare beneficiaries. In turn, Ruiz and her co-conspirators could use the documentation to fraudulently bill Medicare for therapies and treatments that were not medically necessary or ever provided.

It was found that from January 2006 to June 2012, Professional Home Care and LTC fraudulently submitted approximately $74 million in claims for home health care services. Medicare paid approximately $45 million on those false claims.

The 45-year old Ruiz is scheduled to be sentenced on October 8 for the Miami Medicare fraud scheme.

How to Report Miami Medicare Fraud

Healthcare professionals or medical billing employees who have 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 up 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 whistleblowers to document Medicare fraud and other forms of fraud against the government. Contact Miami Whistleblower / Qui Tam lawyer Tod Aronovitz to discuss your case.