Jail Term in $74 Million Miami Home Health Medicare Fraud By Tod Aronovitz | 11/22/13 | 0 Comment

Working as an administrator at one home health care company and as an employee of another, Myriam Acevedo, 63, pleaded guilty to one count of conspiracy to pay health care kickbacks and two counts of payment of kickbacks in connection to a $74 million Miami home health Medicare fraud scheme. For her participation, she was sentenced to 60 months in prison.

The Miami resident was an administrator of LTC Professional Consultants Inc. and an employee of Professional Home Care Solutions Inc., two home health care agencies that allegedly provided home health and therapy services to Medicare beneficiaries.

According to court documents, Acevedo and her co-conspirators operated the two Miami-based companies for the purpose of billing the Medicare program for expensive physical therapy and home health services that were medically unnecessary and/or actually not provided.

The U.S. Attorney’s Office said that Acevedo’s primary role was to pay kickbacks and bribes to patient recruiters of LTC and Professional.  She, along with others, would disburse cash to patient recruiters in exchange for patients, prescriptions, plans of care (POCs), and certifications for medically unnecessary services for Medicare beneficiaries.  Acevedo and her co-conspirators would then use the ill-gotten patient documentation and information to fraudulently bill Medicare.

From approximately September 2007 through June 2012, LTC and Professional submitted about $41 million in fraudulent claims.  Medicare paid the companies approximately $27 million as a result.  Acevedo, who knew she was in violation of federal criminal laws, was part of a larger scheme that ultimately billed Medicare more than $74 million in false claims.

This case was investigated by the FBI and HHS-OIG and 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.

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.