The owner and an employee of a Miami home health care agency were sentenced
today to 108 months and 46 months in prison, respectively, for their
participation in a $22 million Medicare fraud scheme, announced the Department
of Justice, the FBI, and the Department
of Health and Human Services (HHS).
U.S. District Judge Patricia A. Seitz in Miami sentenced Marietha Morales,
38, to 108 months in prison and Eduardo Saborit-Dominguez, 48, to 46 months in
prison. Both defendants were each sentenced to three years of supervised
release. In addition, Morales was ordered to pay $14 million in restitution and
Dominugez was ordered to pay $2 million in restitution, jointly and severally
with each other.
Last year, Morales pleaded guilty to one count of conspiracy to commit health care fraud, and Dominguez
pleaded guilty to one count of conspiracy to defraud the United States and to
receive and pay health care kickbacks.
Morales was the president and Dominguez was an employee of Prime Home Health
Services Inc., a Florida home health agency that purported to provide home
health care and physical therapy services to eligible Medicare
beneficiaries.
According to plea documents, Morales conspired with patient recruiters for
the purpose of billing the Medicare program for unnecessary home health care and
therapy services. Morales and her co-conspirators paid kickbacks and bribes to
patient recruiters in return for the recruiters providing patients to Prime Home
Health, as well as prescriptions, plans of care (POCs), and certifications for
medically unnecessary therapy and home health services for Medicare
beneficiaries. Dominguez distributed the kickbacks and bribes to co-conspirator
patient recruiters and knew that the payment of kickbacks and bribes was in
violation of federal criminal laws. Morales used these prescriptions, POCs, and
medical certifications to fraudulently bill Medicare for home health care
services, which Morales knew was in violation of federal criminal laws.
According to plea documents, nurses and office staff at Prime Home Health
falsified patient files for Medicare beneficiaries to make it appear that such
beneficiaries qualified for home health care and therapy services. Morales
admitted that she knew the beneficiaries did not actually qualify for and did
not receive such services. Morales knew that these files were falsified so that
Medicare could be billed for medically unnecessary therapy and home health
related services.
From approximately February 2005 through April 2011, Morales and her
co-conspirators submitted approximately $22 million in false and fraudulent
claims to Medicare. Medicare actually paid approximately $14 million on those
claims.
The sentences were announced by Assistant Attorney General Lanny A. Breuer of
the Justice Department’s Criminal Division; 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; and
Special 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 Senior Trial 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 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.
Since their inception in March 2007, Medicare Fraud Strike Force operations
in nine locations have charged more than 1,330 defendants who collectively have
falsely billed the Medicare program for more than $4 billion. In addition, the
HHS Centers for Medicare and Medicaid Services, working in conjunction with the
HHS-OIG, are taking steps to increase accountability and decrease the presence
of fraudulent providers
To learn more about the Health Care Fraud Prevention and Enforcement Action
Team (HEAT), go to: www.stopmedicarefraud.gov.
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