Two Home Health Recruiters Sentenced for $48 Million Fraud Scheme

Two patient recruiters for Florida home health companies were sentenced on Dec. 12 for their roles in a $48 million Medicare fraud scheme, the Justice Department announced.

Elizabeth Monteagudo received a 70-month prison sentence followed by three years of supervised release and was also ordered to pay $3.5 million in restitution jointly and severally with co-defendants.  

Cristobal Gonzalez was sentenced to serve 46 months in prison followed by two years of supervised release and was ordered to pay $2 million in restitution jointly and severally with codefendants. 

The pair each pleaded guilty to count count of conspiring to receive health care kickbacks, and Monteagudo additionally pleaded guilty to receiving kickbacks in connection with a federal health care program.

Both defendants were patient recruiters who worked for Caring Nurse Home Health Care Corp. Gonzalez also worked for Good Quality Home Health Care Inc. The two home health agencies purportedly provide home health and therapy services to Medicare beneficiaries. 

Between approximately January 2009 through about June 2011, Monteagudo and Gonzalez would recruit patients for the two home health agencies and would solicit and receive kickbacks and bribes from the owners and operators of those companies in return for allowing the agency to bill Medicare on behalf of the recruited patients, according to court documents.

These Medicare beneficiaries were billed for home health care and therapy services that were either medically unnecessary or not provided.

Monteagudo also admitted to her role in $7 million of fraudulent billings for Starlite Home Health Agency Inc., which she owned and operated. 

Caring Nurse and Good Quality submitted approximately $48 million in claims for unnecessary or unprovided home health services, of which Medicare paid approximately $33 million. The owners and operators of these two companies have previously been indicted and sentenced

Written by Alyssa Gerace