The owners of a Miami home health care agency pleaded guilty on Monday for their participation in a $20 million Medicare fraud scheme for false billings for home care services.
Ariel Rodriguez and Reynaldo Navaro were the owners of Serendipity Home Health, an agency based in Florida that said it purported to provide services to Medicare beneficiaries.
To run the scheme, Rodriguez and Reynaldo paid recruiters kickbacks for referrals given to Serendipity for prescriptions, plans of care (POCs) and certifications for medically unnecessary therapy and home health services. The company would then fraudulently bill the Medicare program.
According to plea documents, Serendipity nurses and office staff falsified patient files for Medicare beneficiaries to make it appear that the beneficiaries qualified for home health care and therapy services, when they in fact did not actually qualify.
According to the Department of Justice, the company submitted approximately $20 million in false and fraudulent claims to Medicare, which they were paid approximately $14 million.
The case is being prosecuted by Trial Attorney Joseph S Beemsterboer of the Criminal Division’s Fraud Section. The case was investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the United States Attorney’s Office for the Southern District of Florida.
Written by John Yedinak