Miami Home Health Fraudsters Sentenced for $8 Million Scheme

Two former owners of a home health care company in Miami, Florida were sentenced this week for their roles in a health care fraud scheme that bilked the federal government out of $8 million in Medicare dollars.

The former owners of Flores Home Health Care Inc., Miguel Jiminez and Marina Sanchez Pajon, were sentenced to 87 months and 57 months in prison, respectively, after pleading guilty to conspiracy to commit health care fraud.

The former company was established for the purpose of billing Medicare for physical therapy and home care services that were not provided or were not medically necessary, according to court documents. Both of the owners took part in negotiating and paying kickbacks and bribes to patient recruiters and coordinated the submission of fraudulent Medicare claims. 

The scheme, which ran from October 2009 through June 2012, according to the Justice Department, amounted to payment of approximately $8 million by Medicare for fraudulent home health claims.

Miami has been identified as an area of high Medicare fraud concentration, leading to a moratorium placed in July by the Centers for Medicare and Medicaid Services on new home health market entrants in the metro area. 

Written by Elizabeth Ecker