Patient Recruiter Sentenced in $20 Million Home Health Kickback Scheme

The former patient recruiter for a Miami home health agency charged with $20 million in fraudulent Medicare billing has been sentenced to 37 months in prison and has been ordered to pay $1.85 million in restitution for his participation in the scheme. 

Manuel Lozano pleaded guilty to one count of conspiracy to receive health care kickbacks for his participation in the fraud during his work as a patient recruiter for Miami home health company Serendipity Home Health and was sentenced this week to prison, the restitution payment as well as two years of supervised release. 

Lozano was a patient recruiter for Serendipity, where he recruited patients for the company, in doing so soliciting and receiving kickbacks and bribes from the company’s owners, according to court documents. In return, he allowed the company to bill Medicare on behalf of the patients he recruited for services that were medically unnecessary or were not provided. 

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Over the period from January 2006 to March 2009, the company submitted $20 million in false Medicare claims, receiving $14 million for the claims. 

“As a result of Lozano’s participation in the illegal scheme, the Medicare program was fraudulently billed more than $1 million but less than $2.5 million for purported home health care services,” according to the Department of Justice. 

In a related case a related case, Serendipity’s former owners Ariel Rodriguez and Reynaldo Navarro were sentenced to 73 and 74 months in prison, respectively, and ordered to pay $14 million in restitution. 

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The case is being prosecuted by Assistant Chief Joseph S. Beemsterboer of the Criminal Division’s Fraud Section. It was investigated by the FBI and HHS-OIG, and brought as part of the Medicare Fraud Strike Force, an initiative supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida. 

Written by Elizabeth Ecker

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