Miami Clinic Owner Pleads Guilty to $20 Million Home Health Fraud

The owner and operator of a Miami-based medical clinic pleaded guilty Tuesday in connection with over $20 million of home health and other healthcare-related fraud. 

Miami resident Isabel Medina, 49, pleaded guilty before a U.S. Southern District of Florida judge for conspiracy to commit healthcare fraud, which allegedly involved fraudulently billing for home health care services and therapy prescriptions to patients that may not have required them, according to the Department of Justice (DOJ).

Medina was the owner and operator of Merfi, a Miami medical clinic which employed physicians, physician assistants and other medical professionals authorized to dispense prescriptions for home health care services.

Through Merfi, Median and her co-conspirators allegedly provided fraudulent home health and therapy prescriptions and other medical documentation to the owners and operators of Flores Home Health Care Inc., among other home health agencies and patient recruiters, in return for kickbacks and bribes, DOJ notes. 

“Medina has acknowledged that her involvement in fraudulent schemes at multiple home health care companies, including Flores Home Health, resulted in losses to the Medicare Program exceeding $20 million,” said DOJ in a statement. 

Conspiracy to commit health care fraud carries a maximum penalty of 10 years in prison. Medina is scheduled for sentencing March 14, 2014.

Tuesday’s announcement is the latest action taken by the Medicare Fraud Strike Task Force, which has charged more than 1,700 defendants who have collectively billed the Medicare program for more than $5.5 billion since the agency’s inception in March 2007. 

Miami, along with Chicago and Houston, have been deemed as “hot spots” for fraud by the Centers for Medicare & Medicaid Services (CMS), who imposed the first-ever home health moratorium in July 2013 that barred new providers from entering into the Medicare program in these areas. 

Written by Jason Oliva

Jason Oliva

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