Professional Home Health Clinic Owner Pleads Guilty in $6.2 Million Miami Medicare Fraud By Tod Aronovitz | 12/04/14 | 0 Comment

It appears that one fraudulent scheme wasn’t enough for Ernesto Fernandez.  The 48-year old owner and operator of three Miami home health care agencies has been tied to a long-running $6.2 million Medicare fraud scheme at his company, Professional Medical Home Health LLC (also known as Professional Home Health), in addition to similar schemes at two other home health care agencies he owned in South Florida.

According to an announcement by the U.S. Attorney’s Office-Southern District of Florida, Fernandez pleaded guilty to one count of conspiracy to commit health care fraud before U.S. Magistrate Judge Chris M. McAliley of the Southern District of Florida. Under the terms of his plea agreement, he will also forfeit $9,061,867, which represented the proceeds traceable to his criminal conduct.

Through numerous admissions, Fernandez revealed that he and his co-conspirators billed Medicare for expensive therapies and services that were not medically necessary nor provided by Professional Home Health and his two other agencies.  Fernandez also acknowledged that he caused patient documentation to be falsified; managed and supervised personnel; and planned, organized and oversaw the submission of fraudulent claims submitted to the Medicare program.

In addition, Fernandez acted as a patient recruiter for all three home health agencies, recruiting patients in exchange for kickbacks and knowing that his agencies would bill the Medicare program on behalf of these recruited patients for therapies and services not administered.

Fernandez was the eighth defendant to plead guilty in connection with the fraudulent schemes at Professional Home Health. His sentencing is scheduled for February 3, 2015.

Five other individuals charged in this case pleaded guilty at the beginning of November, while two additional defendants were sentenced earlier this year in connection to the same scheme.

Alina Hernandez, 38, of West Palm Beach, and Dennis Hernandez, 32, Jose Alvarez, 48, and Joel San Pedro, 44, all of Miami, each pleaded guilty to one count of conspiracy to commit health care fraud.  In addition, Juan Valdes, 37, of Palm Springs, pleaded guilty to one count of conspiracy to defraud the United States and receive health care kickbacks. Sentencing hearings for the five are set for January 29, 2015.

Annarella Garcia, an owner of Professional Home Health, was sentenced to serve 70 months in prison, while Annilet Dominguez, an administrator of Professional Home Health, was sentenced to serve 68 months in prison. Both were also ordered to pay $6,257,142 in restitution.

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.