Owner and Employee of Miami Home Health Company Sentenced to Prison in $22 Million Medicare Fraud Scheme

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WASHINGTON—The owner and an employee ofa Miami home health care agency were sentenced today to 108 months and 46months in prison, respectively, for their participation in a $22 millionMedicare fraud scheme, announced the Department of Justice, the FBI, and theDepartment of Health and Human Services (HHS).
U.S. District Judge Patricia A. Seitz inMiami sentenced Marietha Morales, 38, to 108 months in prison and EduardoSaborit-Dominguez, 48, to 46 months in prison. Both defendants were eachsentenced to three years of supervised release. In addition, Morales wasordered to pay $14 million in restitution and Dominugez was ordered to pay $2million in restitution, jointly and severally with each other.
Last year, Morales pleaded guilty to onecount of conspiracy to commit health care fraud, and Dominguez pleaded guiltyto one count of conspiracy to defraud the United States and to receive and payhealth care kickbacks.
Morales was the president and Dominguezwas an employee of Prime Home Health Services Inc., a Florida home healthagency that purported to provide home health care and physical therapy servicesto eligible Medicare beneficiaries.
According to plea documents, Moralesconspired with patient recruiters for the purpose of billing the Medicare programfor unnecessary home health care and therapy services. Morales and herco-conspirators paid kickbacks and bribes to patient recruiters in return forthe recruiters providing patients to Prime Home Health, as well asprescriptions, plans of care (POCs), and certifications for medicallyunnecessary therapy and home health services for Medicare beneficiaries.Dominguez distributed the kickbacks and bribes to co-conspirator patientrecruiters and knew that the payment of kickbacks and bribes was in violationof federal criminal laws. Morales used these prescriptions, POCs, and medicalcertifications to fraudulently bill Medicare for home health care services,which Morales knew was in violation of federal criminal laws.
According to plea documents, nurses andoffice staff at Prime Home Health falsified patient files for Medicarebeneficiaries to make it appear that such beneficiaries qualified for homehealth care and therapy services. Morales admitted that she knew thebeneficiaries did not actually qualify for and did not receive such services.Morales knew that these files were falsified so that Medicare could be billedfor medically unnecessary therapy and home health related services.
From approximately February 2005 throughApril 2011, Morales and her co-conspirators submitted approximately $22 millionin false and fraudulent claims to Medicare. Medicare actually paidapproximately $14 million on those claims.
The sentences were announced byAssistant Attorney General Lanny A. Breuer of the Justice Department’s CriminalDivision; U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida;John V. Gillies, Special Agent in Charge of the FBI’s Miami Field Office; andSpecial Agent in Charge Christopher Dennis of the HHS Office of Inspector General(HHS-OIG), Office of Investigations Miami Office.
This case is being prosecuted by SeniorTrial Attorney Joseph S. Beemsterboer of the Criminal Division’s Fraud Section.The case was investigated by the FBI and HHS-OIG, and was brought as part ofthe Medicare Fraud Strike Force, supervised by the Criminal Division’s FraudSection and the U.S. Attorney’s Office for the Southern District of Florida.
Since their inception in March 2007,Medicare Fraud Strike Force operations in nine locations have charged more than1,330 defendants who collectively have falsely billed the Medicare program formore than $4 billion. In addition, the HHS Centers for Medicare and MedicaidServices, working in conjunction with the HHS-OIG, are taking steps to increaseaccountability and decrease the presence of fraudulent providers
To learn more about the Health CareFraud Prevention and Enforcement Action Team (HEAT), go to:www.stopmedicarefraud.gov.