The owner and operator of a Miami home health care agency was sentenced Monday to 106 months in prison for his participation in a $30 million Medicare fraud scheme, according to FBI reports.
Ramon Regueira, 66, of Miami, pleaded guilty to one count of conspiracy to commit health care fraud on Nov. 13, 2014, according to FBI reports. In addition to the prison sentence, U.S. District Judge Cecilia M. Altonaga of the Southern District of Florida ordered Regueira to pay $21 million in restitution, both jointly and severally with his co-conspirator.
According to his plea agreement, Regueira was an owner of Nation’s Best Care Home Health Corp., a Miami home health care agency that purported to provide home health and therapy services to Medicare beneficiaries.
Regueira allegedly admitted that he and his co-conspirators operated Nation’s Best for the purpose of billing the Medicare program for, among other things, expensive physical therapy and home health care services that were not medically necessary or not provided.
“Specifically, Regueira admitted that he and his co-conspirators paid kickbacks and bribes to patient recruiters who provided patients to Nation’s Best, as well as prescriptions, plans of care (POCs) and certifications for medically unnecessary therapy and home health services,” says the FBI in a statement.
Regueira and his co-conspirators then used these prescriptions, POCs and medical certifications to fraudulently bill the Medicare program for “unnecessary” home health care services, the FBI says.
From January 2007 through January 2011, Nation’s Best allegedly submitted about $30 million in claims for home health services that were not medically necessary or not provided, and Medicare paid approximately $21 million for these fraudulent claims, according to FBI reports.
The case was investigated by the FBI and U.S. Department of Health and Human Services, Office of Inspector General’s (HHS-OIG), and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida.
This case is being prosecuted by Assistant Chief Joseph S. Beemsterboer and Trial Attorney Kelly Graves of the Criminal Division’s Fraud Section.
Written by Cassandra Dowell