Home Health Fraudster Gets 20 Years Behind Bars

The owner of JEM Home Health Care LLC (JEM) and Health Choice Home Services Inc., and manager of Willsand Home Health Agency Inc., all located in the Miami area, was sentenced to 20 years in prison for playing a role in a $57 million Medicare fraud scheme.

After a two-week trial, Khaled Elbeblawy, of Miramar, Florida, was convicted of one count of conspiracy to commit health care fraud and wire fraud and one count of conspiracy to defraud the United States and pay health care kickbacks. This week, he was sentenced in South Florida by U.S. District Judge Beth Bloom and ordered to pay approximately $36.4 million in restitution and to forfeit the same amount.

The evidence showed that through the three home health agencies, Elbeblawy and co-conspirators falsely claimed to provide home health services to Medicare beneficiaries, which were not medically necessary and often were not even provided.

Elbeblawy and his con-conspirators paid kickbacks to doctors, patient recruiters and staffing groups, which then referred beneficiaries to Willsand, JEM and Health Choice, the evidence showed.

In total, the three agencies submitted approximately $57 million in false and fraudulent claims to Medicare, according to evidence presented at trial. Of the $57 million, the agencies received payments totaling approximately $40 million from the claims.

The three agencies also had other individuals in leadership roles charged for the fraud scheme. The former owner of Willsand and former co-owner of JEM, Eulises Escalona, pleaded guilty to one count of conspiracy to commit health care fraud and was sentenced to 10 years in prison. The former co-owner of Healthy Choice, Cynthia Vilches, also pleaded guilty to one count of conspiracy to commit health care fraud. VIlches will be sentenced on Oct. 13, 2016.

The Medicare Fraud Strike Force, which is supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office of the Southern District of Florida, brought on the FBI and HHS-OIG to investigate Elbeblawy’s case.

Since 2007, when the Medicare Fraud Strike Task Force was formed, there have been over 2,000 people charged, who collectively billed Medicare for more than $10 billion.

Written by Alana Stramowski