Four patient recruiters have pleaded guilty for their participation in a home health fraud scheme that bilked the federal government out of an estimated $20 million in Medicare dollars.
The four recruiters, Estrella Perez, Solchys Perez, Abigail Aguila and Monica Macias pleaded guilty last week to various charges including conspiracy to defraud the United States, for their work as patient recruiters for Trust Care, a Miami home health care agency. As a home health agency, Trust Care provided home health and physical therapy services to Medicare beneficiaries in the Miami area.
Working as patient recruiters, Perez, Perez, Aguila and Macias recruited patients and solicited and received kickbacks and bribes from the company owners, according to court documents. In return, Trust care billed Medicare on behalf of the recruited patients, who were billed for home health and physical therapy services that were either not medically necessary or were not provided.
In addition, Estrella Perez and Solchys Perez also paid kickbacks and bribes to contacts in doctors’ offices and clinics in exchange for home health and therapy prescriptions, care plans and medical certifications for the recruited patients. Those prescriptions and care plans were later used to bill Medicare fraudulently for home health services.
From March 2007 through at least January 2010, Trust Care was responsible for submitting more than $20 million in claims for home health services; $15 million of which Medicare paid for the fraudulent claims, according to the court documents.
Miami has been identified as a major metro area with one of the highest instances of home health care fraud nationwide. In July 2013, the Centers for Medicare and Medicaid services imposed the first-ever moratorium on new entrants to the home health market, specifically targeted at the Chicago and Miami metro areas.
Written by Elizabeth Ecker