They have notoriously bad handwriting, but their signatures are priceless.
Especially in South Florida’s Medicare rackets.
Three Miami physicians have been charged in recent months with signing prescriptions for costly home healthcare services that federal prosecutors say were not needed or provided. They’re accused of receiving kickbacks of $150 a patient on average in exchange for referrals to numerous Miami-Dade healthcare agencies that filed tens of millions of dollars in false claims with the taxpayer-funded Medicare program.
Medicare, which still struggles with lax oversight after years of losing billions of dollars to fraud, routinely paid the bogus bills because of the physicians’ signatures. They authorized purported services such as insulin injections, physical therapy and nursing care for home-bound patients.
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The three physicians — among a total of more than 60 South Florida doctors prosecuted by the U.S. attorney’s office over the last decade-plus — have signed or are expected to reach plea deals to limit their prison time.
▪ Yamile Duain Porro, 70, who received a medical degree from the University of Havana, was sentenced Thursday to seven months in prison and seven months under house arrest after pleading guilty to accepting kickbacks for patient referrals. She was also ordered to pay a $5,000 fine by U.S. District Judge Kathleen Williams.
Porro, before her arrest, had fretted about getting caught for Medicare fraud in undercover recordings with a convicted patient recruiter who was assisting federal investigators. She also told the cooperating defendant that a Miami Herald story about Cuban immigrants ripping off Medicare and fleeing to Cuba to evade justice was “driving her crazy.”
“What these conversations show is that Porro was not some unwitting dupe entrapped by the [cooperating defendant],” Assistant U.S. Attorney James Hayes wrote in a court filing. “Porro knew full well what she was doing.”
Her defense attorney, Joaquin Mendez, argued that although her “professional judgment was compromised by kickback payments . . . it was certainly easier for her to get involved in this offense and rationalize her misconduct given the genuine medical needs of the patients she was brought.”
▪ Henry Lora, 51, who obtained his medical degree in the Dominican Republic, pleaded guilty Tuesday to conspiring to commit healthcare fraud, receive kickbacks and falsify records in his role as medical director of a Miami clinic, Merfi Corp.
In his plea agreement, Lora admitted that in exchange for bribes, he wrote phony prescriptions for home healthcare services and falsified patient records to make it look like the Medicare patients needed them. He also acknowledged that he conspired with Merfi’s owner, Isabel Medina, who pleaded guilty in 2014 and is serving nine years in prison.
As a result of the clinic’s wrongdoing, Medicare paid out $20 million to Miami-Dade agencies that falsely billed the program over a seven-year period, Justice Department prosecutors said.
Lora is scheduled to be sentenced in April in Miami federal court.
▪ Of the three physicians charged with Medicare fraud, Kansky Jean Delisma boasts the most prestigious academic credentials. The 48-year-old doctor obtained his medical degree from Howard University, then completed his primary-care residency at Yale University followed by a master’s in public health from Harvard University.
On Wednesday, Delisma pleaded not guilty in Miami federal court to charges of accepting $700 in kickbacks for patient referrals to home healthcare agencies.
Delisma has been charged by information, not indictment, which means he is negotiating a plea deal, authorities said. His attorney, Ronald Chapman, declined to comment.
As part of that planned agreement, Delisma must reimburse Medicare $49,000 for false bills submitted in the names of patients whom he referred to home healthcare agencies.
Delisma was caught in an undercover operation involving the former owner of two Miami-Dade agencies: Khaled Elbeblawy. Although he cooperated with federal investigators for more than a year, Elbeblawy chose to go to trial in January rather than cut a plea deal.
Elbeblawy, who fired his defense attorney and represented himself at trial, was convicted of falsely billing Medicare $56 million for services that were neither needed nor provided. The 39-year-old businessman was found guilty of conspiring to bilk the program and pay kickbacks for patient referrals.
Justice Department prosecutors say Medicare, as a result of his misconduct, paid out $40 million. Elbeblawy will be sentenced in April.