South Florida | Medicare fraud

Medicare fraud crackdown nets 33 arrests in South Florida

 

Federal authorities charged more than 30 South Florida suspects with Medicare fraud, including some associated with a Hollywood psychiatric hospital.

 

A Federal Agent enters the offices of Professional Home Care Solutions Home Health Agency located on SW 47th street and 71st avenue in Miami, suspected of Medicare Fraud on October 3, 2012
A Federal Agent enters the offices of Professional Home Care Solutions Home Health Agency located on SW 47th street and 71st avenue in Miami, suspected of Medicare Fraud on October 3, 2012
C.M. GUERRERO / EL NUEVO HERALD
Upload and share your own.

You can share related videos and photos.

Submit: Video Pictures Stories

jweaver@MiamiHerald.com

A patient broker from Alabama, Gloria Himmons, was charged with receiving the kickbacks to supply the Medicare beneficiaries.

Kallen-Zury attempted to conceal the kickbacks by creating false documents to make it appear as if the services were legitimate, prosecutors said.

Kallen-Zury’s lawyer, Pasano, described his client as a hard-working woman who took over the 40-year business from her father and has lived an honorable life catering to women and men with psychological illnesses, such as schizophrenia and bipolar disorders.

Over the past two years, the Justice Department has scored dozens of convictions in major mental-healthcare fraud cases against two Miami-Dade based psychotherapy clinics, American Therapeutic and Biscayne Milieu, which fleeced Medicare for tens of millions of dollars. American Therapeutic’s one-time owner, Lawrence Duran, is serving a 50-year prison sentence — the stiffest punishment ever against a Medicare fraud offender.

Cooperating defendants in those and related cases helped prosecutors build their indictment against Hollywood Pavilion, according to court records.

Among the other indictments unveiled in South Florida Thursday were cases against these Miami-Dade medical providers:

• Sila Luis, owner of LTC Professional Consultants, who was charged with paying kickbacks to recruiters and patients, allegedly submitted false claims for skilled nurses to administer insulin injections for homebound patients who didn’t need the services. Co-defendant Elsa Ruiz, owner of Professional Home Care Solutions, was also charged with paying bribes to carry out the same scheme.

Their two businesses submitted $74 million in fraudulent bills to Medicare for purported skilled nursing and physical therapy services, according to an indictment. As a result, the federal program paid out $50 million.

• Rogelio Rodriguez, owner of Caring Nurse Home Health and Good Quality Home Health, was charged with a similar scheme to bilk Medicare for purported nursing services to treat homebound diabetic patients. His companies, which filed $53 million in phony claims, were paid $34 million, according to an indictment.

Also charged in the case: Raymond Aday, a recruiter who allegedly received kickbacks from Rodriguez for supplying Medicare patients for the home care businesses.

Read more Broward - South stories from the Miami Herald

Miami Herald

Join the
Discussion

The Miami Herald is pleased to provide this opportunity to share information, experiences and observations about what's in the news. Some of the comments may be reprinted elsewhere on the site or in the newspaper. We encourage lively, open debate on the issues of the day, and ask that you refrain from profanity, hate speech, personal comments and remarks that are off point. Thank you for taking the time to offer your thoughts.

The Miami Herald uses Facebook's commenting system. You need to log in with a Facebook account in order to comment. If you have questions about commenting with your Facebook account, click here.

Have a news tip? You can send it anonymously. Click here to send us your tip - or - consider joining the Public Insight Network and become a source for The Miami Herald and el Nuevo Herald.

Hide Comments

This affects comments on all stories.

Cancel OK