A healthcare operator who once won an entrepreneur of the year award from the Latin Chamber of Commerce in Miami will be heading to prison for five years for submitting more than $16 million in phony claims to the taxpayer-funded Medicare program.
Martha Lima, 82, must surrender in early November after pleading guilty to a conspiracy to pay kickbacks to doctors for patient referrals to her home healthcare agency.
Her son, Luis Lima, 56, who pleaded guilty to a conspiracy to defraud the Medicare program, received the same punishment as his mother — though he could have been sent to prison for twice as long under federal sentencing guidelines. The son must surrender in mid-June to start his five-year term.
The son’s defense attorney, Luis Fernandez, argued for less time at a hearing this month before U.S. district Judge Robert Scola, noting his role in persuading his mother to plead guilty along with him.
“Mr. Lima was instrumental in getting his co-defendant mother to enter” a guilty plea, Fernandez wrote in court papers, asserting that “his role in the offense was significantly less than” that of the mother, yet he was facing twice as much time in prison. “This should be avoided as both are guilty of similar conduct in the same case.”
Martha Lima opted for the plea deal rather than go ahead with a trial because the deal capped her potential prison time, according to the agreement reached by her attorney, Jose Quinon, and the U.S. attorney’s office.
Martha Lima, who had received an entrepreneurial award from the Latin Chamber of Commerce of the United States (CAMACOL) in 2013, submitted her resignation from the group’s board of directors last October, just before the Miami Herald reported on her Medicare fraud scheme.
While such corruption is commonplace in Miami, the nation’s reputed capital of Medicare fraud, the Lima case sticks out because of the mother’s former high profile in the home healthcare field, on the CAMACOL board and in the Cuban exile community.
According to an indictment, Lima opened Continuous Home Care Services in 2005, purportedly providing skilled nursing services, physical therapy and other aid to home-bound Medicare patients. That same year, she also founded a charity, Bridge of Love and Hope.
Both the mother and son were initially accused of conspiring to submit “false and fraudulent claims” to Medicare, “concealing” the program's payments and “diverting fraud proceeds for the personal use and benefit of themselves and others.”
Both were also initially charged with paying kickbacks to doctors for patient referrals, which required signing off on “plans of care” for patients who purportedly needed healthcare services at home because they were physically unable to visit a medical office.
The mother and her co-conspirators also paid thousands of dollars in kickbacks to patient recruiters who provided a steady stream of Medicare patients to Continuous, the indictment said. And, they paid bribes to Continuous patients, using the charity, Bridge of Love and Hope, as a conduit, prosecutor Amanda Perwin alleged.
Perwin is seeking to recover $16.3 million from the Limas in a forfeiture action, which represents their total bogus claims submitted to Medicare.