Miami Home Care Worker Pleads Guilty in $7M Kickback Fraud

An office worker with a Miami home health care company pleaded guilty Wednesday to her involvement in a $7 million fraud scheme, according to the U.S. Department of Justice.

Lizette Garcia, 37, of Miami, pleaded guilty before U.S. District Judge Joan A. Lenard in the Southern District of Florida to one count of payment of health care kickbacks.

Garcia, who worked as an office worker at Anna Nursing Services Corp., paid kickbacks and bribes to patient recruiters in return for the recruiters providing patients to the company for home health care and therapy services that were medically unnecessary or were not provided, according to court documents.

From October 2010 through April 2013, Anna Nursing was paid by Medicare approximately $7 million for fraudulent claims for home health services that were either not rendered or were not medically necessary.

The case was investigated by the FBI and the Department of Health and Human Services Office of the Inspector General, which has spearheaded numerous initiatives against fraudulent and abusive practices to the Medicare program nationwide.  

Miami has been considered a hotspot for aberrant billing behavior by several federal regulators, most notable of which being the Centers for Medicare & Medicaid Services (CMS).

Last year, CMS imposed its first-ever home health moratorium to bar the entry of new providers in the Miami-Dade and Monroe counties, as well as several counties in Illinois and Texas. 

Since 2011, CMS has revoked 14,663 providers’ and suppliers’ abilities to bill in the Medicare program for reasons including, but not limited to, felony convictions and noncompliance with federal regulations. 

The case against Garcia is being executed under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida. 

Sentencing for Garcia is scheduled for August 27, 2014. 

Written by Jason Oliva

Jason Oliva