Martha Lima was sitting atop Miami’s home healthcare industry just three years ago.
Lima was recognized as the “Entrepreneur of the Year” by the Latin Chamber of Commerce of the United States, also known as CAMACOL. It’s the largest Hispanic business organization in Florida.
But in mid-November, the 82-year-old head of a home healthcare business is scheduled to be judged by a different kind of group — a federal jury. They will decide whether she masterminded a multimillion-dollar scam against the taxpayer-funded Medicare program through Continuous Home Health Care Services — the very business cited in her 2013 award from CAMACOL.
Lima, who is a member of the CAMACOL board, faces trial along with her son, Luis. They are accused of defrauding Medicare by filing $16 million in false claims and paying bribes to patients, recruiters and doctors from 2009 to 2014.
While such corruption charges are commonplace in Miami, the nation’s reputed capital of Medicare fraud, the Lima case sticks out because of the mother’s high profile in the home healthcare field, on the CAMACOL board and in the Cuban exile community.
Moreover, during the past decade, home healthcare as an industry became such a hotbed of fraud in South Florida that Medicare imposed a cap on billing for home-bound patients with diabetes and other chronic ailments, saving the federal insurance program hundreds of millions of dollars.
Although the Lima indictment was filed in February, CAMACOL’s interim president said she only learned about it in recent weeks and now plans to seek her removal from the board at its next meeting on Wednesday.
“As of right now, she is still on the board,” said CAMACOL’s interim president, Mercy Saladrigas, an attorney. “I will bring up this matter at the board’s next meeting.”
Martha Lima’s defense attorney, Jose Quinon, declined to comment. The attorney for her son, Luis, said a plea agreement is being pursued with the U.S. attorney’s office for both defendants and the goal would be to minimize any possible jail time.
“At this point in time, all the parties are working toward finding a solution to this case,” said attorney Luis Fernandez.
According to the indictment, Martha Lima opened Continuous Home Health 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 are 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.”
The defendants “falsely and fraudulently represented that home health and physical therapy services were medically necessary, prescribed by a doctor, and had been provided to the Medicare beneficiaries by Continuous,” according to the indictment.
They are also 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, son and their 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 claims submitted to Medicare.
If the mother and son are convicted and cannot repay that sum, the prosecutor plans to seize substitute assets owned by them. The indictment lists 10 Miami-Dade real estate properties, most of them located in the Little Havana neighborhood.