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Compliance News: Five plead guilty in massive Medicare fraud
From: Eric Newman
To: Florida & SE Region community
Posted: 07-30-2010 14:36
Subject: Compliance News: Five plead guilty in massive Medicare fraud
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This message has been cross posted to the following eGroups: Chief C & E Officer Health Care Network and Florida & SE Region community .
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Five South Floridians pleaded guilty Thursday in Miami federal court to their roles in a massive Medicare fraud scheme.

Arturo Fonseca, 47; Isis Torres, 37; Francisco Portillo, 41; Eduardo Romero, 44; and William Madrigal, 56 were among 26 suspects in three states indicted in December 2009 on charges of running the scheme that totaled $61 million, according to the U.S. Department of Justice.

At the plea hearing, Fonseca admitted to being an owner and operator of Courtesy Medical Group Inc., a purported medical clinic in Miami. According to court documents, Courtesy provided medical documents so that the home health agencies could bill the Medicare program for expensive home health services and therapy for beneficiaries that did not need and in some cases did not receive the treatments. According to the indictment, approximately 344 prescriptions were issued through Courtesy and signed by Fonseca's co-defendant, Dr. Fred Dweck. As a result, the Medicare program was fraudulently billed approximately $16.6 million for home health services.

According to plea documents, Romero admitted to being a patient recruiter for ABC Home Health Care Inc., and Florida Home Health Care Providers Inc., two Miami-area home health care agencies. Romero admitted that in his role as a patient recruiter, he would solicit and receive kickbacks and bribes from the owners of ABC and Florida Home Health in return for providing Medicare beneficiaries that the home health agencies could use to bill the Medicare program for unnecessary home health care services. Romero also admitted to paying kickbacks and bribes to the owners and operators of Courtesy in return for the prescriptions for unnecessary home health care services.

Medicare was billed approximately $391,593 for home health care services that were not medically necessary or were not rendered for the patients recruited by Romero and one of his co-defendants.

The owners and operators of ABC and Florida Home Health pleaded guilty in a separate case and are awaiting sentencing



Read more: Five plead guilty in massive Medicare fraud - South Florida Business Journal


More:http://southflorida.bizjournals.com/southflorida/stories/2010/07/26/daily62​.html
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Eric Newman, Esq.
HCCA/SCCE
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Minneapolis, MN

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