Miami Home Health Owner Sentenced In $6 Million Medicare Fraud Scheme

A co-owner of Professional Medical Home Health LLC has been sentenced to serve nearly six years in prison and ordered to pay $6.2 million in restitution for her participation in a health care fraud scheme involving the now defunct home health care company.

Annarella Garcia, 44, of Hialeah, Fla. pleaded guilty to conspiracy to commit health care fraud June 25.

Garcia was a co-owner of Professional Medical Home Health, a Miami home health care agency that purported to provide home health and therapy services to Medicare beneficiaries.

Between December 2008 and February 2014, Garcia and others engaged in a scheme to bill the Medicare Program for expensive physical therapy and home health care services that were not medically necessary or were not provided, according to the Federal Bureau of Investigation (FBI). During that time, Professional Medical Home Health was paid about $6.25 million by Medicare for the fraudulent claims.

Garcia and her co-conspirators allegedly paid kickbacks and bribes to patient recruiters in return for their providing patients to Professional Medical Home Health for home health and therapy services that were not medically necessary or were not provided.

In addition, Garcia and her co-conspirators falsified patient documentation to make it appear that beneficiaries qualified for and received home health care services, when, in fact, many of the beneficiaries did not actually qualify for such services and did not receive such services, the FBI says.

The case was investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida.

Trial attorneys A. Brendan Stewart and Anne P. McNamara of the Criminal Division’s Fraud Section are prosecuting the case.

Written by Cassandra Dowell

Cassandra Dowell