Home Health Fraudster Pleads Guilty to $13 Million Scheme

An owner of a Miami home health care company has pleaded guilty in connection with a $13 million Medicare fraud scheme involving kickbacks and bribes, the Department of Justice (DoJ) announced Tuesday. 

Alexander Lara, of Hollywood, Fla., pleaded guilty to one count of conspiracy to commit health care fraud after allegedly paying kickbacks and bribes to Medicare beneficiaries, doctors’ offices, medical clinics and others in exchange for patient referrals and fraudulent prescriptions to support fraudulent billings to Medicare. 

According to his plea documents, Lara was an owner and operator of Longcare Home Health Corporation, a Miami home health care agency.

In connection with his guilty plea, Lara admitted that he and his co-conspirators operated Longcare Home Health for the purpose of billing the Medicare program for expensive physical therapy and home health care services, among other things, that were not medically necessary or not provided at all.

Lara, an organizer and leader of the schemes at Longcare Home Health, admitted that he personally paid kickbacks and bribes to patient recruiters and Medicare beneficiaries in exchange for patient referrals. He also admitted that he paid kickbacks and bribes to doctors’ offices and clinics in exchange for fraudulent prescriptions for medically unnecessary therapy and home health services for Medicare beneficiaries.

From January 2009 to November 2014, Medicare paid approximately $13.7 million for these fraudulent claims, which Lara admitted he personally oversaw.

A sentencing hearing is scheduled for May 14, 2015.

In other legal news, four people have been arrested in Texas following the return of a federal indictment alleging a conspiracy to commit health care fraud and money laundering, according to the United States Attorney’s Office Southern District of Texas. The scheme involved colluding with home health agencies, the authorities charge.

The indictment alleges that from approximately 2007 through the present, the defendants — Aliksandr Beketav, Mikhail Shiforenko, Alexsandr Voronov and Daniela Gozes-Wagner — conspired to falsely bill Medicare and Medicaid for numerous unnecessary medical tests.

According to the indictment, they paid Medicare and Medicaid beneficiaries to visit so-called “testing facilities” run by the defendants in the Houston area. The defendants also colluded with home health agencies to gain access to homebound beneficiaries in order to conduct diagnostic tests on them, according to the allegations.

The defendants then allegedly caused Medicare and Medicaid to be billed for diagnostic tests that were not performed or were not medically necessary.

According to the indictment, the defendants submitted more than $28 million in fraudulent Medicare and Medicaid claims under the auspices of eight facilities, of which Medicare and Medicaid paid more than $11 million.

If convicted of conspiring to commit health care fraud, each faces up to 10 years in federal prison. For conspiring to launder money, they also face 20 years in federal prison. The Indictment also seeks forfeiture of at least $11.4 million alleged to constitute the proceeds of the scheme.

Written by Emily Study