Trust Care Health and Patient Recruiter Plead Guilty in $20 Million Medicare Fraud By Tod Aronovitz | 09/16/13 | 0 Comment

The former owners and operators of Trust Care Health Services, a Miami home health care agency that allegedly provided home health and physical therapy services to Medicare beneficiaries, pleaded guilty along with a former patient recruiter who worked with them, for their roles in a $20 million Medicare fraud scheme.

Roberto Marrero, 60, Sandra Fernandez Viera, 49, and Enrique Rodriguez, 59, pleaded guilty to charges of conspiracy to commit health care fraud, and to receive and pay health care kickbacks.

From about March 2007 through October 2010, Trust Care allegedly submitted more than $20 million in claims for home health services. In turn, Medicare paid Trust Care more than $15 million for expensive physical therapy and home health care services that were not deemed necessary and/or were not provided.

According to court documents, the whole reason Marrero and Fernandez Viera ran Trust Care was for the purpose of billing Medicare.

Marrero was the brains of the operation; Fernandez Viera managed and supervised personnel at Trust Mark; and co-conspirator Rodriguez offered and paid kickbacks and bribes to Medicare beneficiaries. Marrero and Fernandez Viera were also allegedly responsible for negotiating and paying kickbacks and bribes, and they interacted with patient recruiters, and coordinated and managed the submission of fraudulent claims to Medicare.

In addition to paying patient recruiters, the two owners paid co-conspirators in doctors’ offices and clinics in exchange for home health and therapy prescriptions, medical certifications and other documents, using them in their fraudulent billings to Medicare.

Rodriguez solicited and received kickbacks and bribes from Marrero and Fernandez Viera, in return for his patient recruiting. In many instances, Rodriguez knew that the patients he recruited for Trust Care were not eligible for those services billed to Medicare.

The three also acknowledged involvement in similar fraudulent schemes at several other Miami health care agencies including: Global Nursing Home Health Inc., Lovable Home Health Services Corp., New Concepts In Health Inc., Ubieta Health System Inc., R&M Health Care Inc., Vital Care Home Health Services Inc., Centrum Home Health Care Inc., and A&B Health Services Inc. Estimated losses in those schemes totaled approximately $50 million.

The defendants face a maximum penalty of 10 years in prison for conspiracy to commit health care fraud and five years in prison for conspiracy to receive and pay health care kickbacks. Their sentencing is scheduled for November 12, 2013.

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.