Miami Woman Gets 6 Years For $6.5 Million Home Health Fraud Scheme

The owner and operator of a Miami, Fla., home health care company was sentenced to more than six years in prison Monday for her alleged participation in a $6.5 million Medicare fraud scheme, the U.S. Department of Justice (DOJ) announced. 

Cruz Sonia Collado, 64, was an owner and operator of the now-defunct home health care company, Nestor’s Health Services Inc. (Nestor Home Health), which purported to provide home health and physical therapy services to Medicare beneficiaries. 

Earlier this year, Collado pleaded guilty to one count of conspiracy to offer and pay health care kickbacks and to defraud the United States, and one count of offering and paying health care kickbacks, according to the DOJ. In addition to her prison term of 75 months, Collado was sentenced to serve three years of supervised release and ordered to pay more than $6.5 million in restitution. 

U.S. District Judge Robert N. Scola Jr. of the Southern District of Florida imposed the sentence.

Collado allegedly paid kickbacks and bribes to patient recruiters in return for the recruiters providing patients to Nestor Home Health for home health care and therapy services that were medically unnecessary and, in many instances, not provided, according to court documents. Collado then allegedly fraudulently billed the Medicare program for home health care services on behalf of the recruited patients.

From March 2009 through at least January 2014, Nestor Home Health submitted more than $6.5 million in false claims for home health services, and Medicare paid Nestor Home Health more than $6.1 million for these claims. 

The case was investigated by the Federal Bureau of Investigation and the U.S. Department of Health and Human Services Office of the Inspector General as part of the Medicare Fraud Strike Force. Since 2007, the Strike Force has charged nearly 2,000 defendants who have collectively billed the Medicare program for more than $6 billion. 

Written by Emily Study