Miami Agency Owner Jailed in $74 Million Medicare Home Care Fraud Scheme By Tod Aronovitz | 11/17/14 | 0 Comment

Sentencing was announced for a Miami resident who oversaw a $74 million Medicare home care fraud scheme at two home health companies found to be operating for the sole purpose of ripping off the Medicare program.

For her role in the, Elsa Ruiz, the owner of Professional Home Care Solutions and administrator of LTC Professional Consultants, was sentenced to 80 months in prison and ordered to pay $45 million in restitution, the U.S. Attorney’s Office for the Southern District of Florida said.

We first reported about the 45-year old and her home care fraud scheme on our ARONOVITZ LAW Blog in July when Ms. Ruiz pleaded guilty to one count of conspiracy to commit health care fraud.

According to her admissions during the plea hearing, Ruiz said that she not only managed the Medicare home care fraud scheme but also helped to negotiate and pay kickbacks to patient recruiters for the referral of Medicare patients and for prescriptions, plans of care, and medical certifications. Ruiz and her co-conspirators then used this documentation to illegally bill Medicare for expensive therapies and home health care services, which ended up being medically unnecessary or not provided.

From approximately January 2006 to June 2012, LTC and Professional Home Care submitted an estimated $74 million in false claims to Medicare. Medicare paid approximately $45 million on those claims.

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.