Three Miami Home Health Agency Owners Charged in Fraud Scheme
Three Miami-area home health care agency owners were charged in an indictment for their alleged participation in a health care fraud scheme involving a now-defunct business, the Department of Justice (DOJ) announced in March.
Ailin Consuelo Rodriguez Sigler, 39; Ziola C. Rios, 57; and Thomas A. Rodriguez, 66, were charged in the indictment with one count of conspiracy to commit health care fraud and wire fraud, and three counts of health care fraud. The three operated Florida Patient Care Corp.
The indictment alleges that from approximately January 2011 through November 2014, Sigler, Rios and Rodriguez were involved in a fraudulent scheme whereby they agreed with the owners and operators of multiple home health therapy staffing companies and others to bill Medicare for services that were medically unnecessary, were never provided, or were not eligible for Medicare reimbursement.
Michigan Home Health Employee Sentenced to Prison in $1.6 Million Fraud
An assistant nursing director of a Michigan-based home health care agency was sentenced to 36 months in prison for his role in a scheme involving approximately $1.6 million in fraudulent Medicare claims, according to the DOJ.
Juan Yrorita, 63, of Sterling Heights, Michigan, was also ordered to pay $1,524,951.88 in restitution, jointly and severally with his co-conspriatoes, and to forfeit $49,823.41. Yrorita pleaded guilty to one count of conspiracy to commit health care fraud and wire fraud in November 2017.
As part of his guilty plea, Yrorita admitted he and his co-conspiratoes at Detroit-based Anointed Care Services paid kickbacks to recruit Medicare beneficiaries. He also admitted that as director of nursing, he falsified medical records to support Anointed Care’s claims to Medicare for services that were medically unnecessary and never provided.
Ohio Home Health Owner Sentenced for Committing $2 Million Fraud
Cheryl McGrath, 50, of Guysville, Ohio, was sentenced to 36 months in prison for committing healthcare fraud and willful failure to pay over tax, the DOJ announced.
McGrath, who has owned and operated Home Health Care of Southeast Ohio since 1993, executed a $2.2 million scheme to defraud the Ohio Medicaid program for nursing services that were never rendered, the DOJ stated. McGrath routinely changed the claim information in the billing software to falsely reflect that additional hours of nursing services had been provided, and falsely increased the number of nursing visits from one visit per week to between three and five visits.
She also submitted claims for services for Medicaid beneficiaries who were ineligible because they were residing in nursing homes or were deceased. The scheme ran from 2009 to 2013, according to the DOJ.
McGrath pleaded guilty to health care fraud and tax fraud charges in June 2017. She agreed to pay more than $2.2 million in restitution to the Ohio Medicaid Program and nearly $367,000 to the IRS.
Written by Amy Baxter
