Home Health Recruiter Gets 9 Years for $48M Medicare Fraud Scheme

A patient recruiter for a Miami home health care agency was sentenced on Wednesday to nine years in prison for his role in a $48 million scheme to defraud Medicare, the Justice Department announced.

Emilio Amador was sentenced by U.S. District Judge Federico Moreno in the Southern District of Florida following a guilty plea in September 2013 to one count of conspiring to receive health care kickbacks and two counts of receiving health care kickbacks. 

Amador was also sentenced to serve three years of supervised release and ordered to pay $24 million in restitution, jointly and severally with his co-defendants. 

In his capacity as a patient recruiter for Miami-based Caring Nurse Home Health Care Corp., which purported to provide home health and therapy services to Medicare beneficiaries, Amador allegedly solicited and received kickbacks and bribes from the owners and operators of the agency in return for allowing it to bill Medicare on behalf of patients he had recruited.

The Medicare beneficiaries were then billed for home health care and therapy services that either were medically unnecessary or were never provided. This happened between approximately January 2006 and June 2011, says the Justice Department. 

Amador also pleaded guilty to his involvement with fraudulent billings for Nation’s Best Care Home Health Corp., where he was the owner, operator, and president. The fraudulent billings for this agency totaled approximately $30 million. 

The owners and operators of Caring Nurse and Good Quality, Rogelio Rodriguez and Raymond Aday, have previously been sentenced to serve nine years and 51 months in prison, respectively, following December 2012 guilty pleas to one count each of conspiracy to commit health care fraud charged in an October indictment.

The agency allegedly submitted approximately $48 million in claims for home health services that weren’t medically necessary or were never provided, and Medicare paid approximately $33 million of those claims. 

Written by Alyssa Gerace