On December 19, 2012 the Department of Justice announced the owners and operators of two Miami health care agencies pleaded guilty for their participation in a $48 million home health Medicare fraud scheme. According to plea documents, the owners conspired with patient recruiters for the purpose of billing the Medicare program for unnecessary home health care and therapy services. The owners and their alleged co-conspirators paid kickbacks and bribes to patient recruiters in return for these recruiters providing patients to Caring Nurse Home Health Corp. (“Caring Nurse”) and Good Quality Home Health, Inc. (“Good Quality”), as well as prescriptions, plans of care (POCs) and certifications for medically unnecessary therapy and home health services for Medicare beneficiaries. The owners used these prescriptions, POCs and medical certifications to fraudulently bill the Medicare program for home health care services, which the owners knew was in violation of federal criminal laws.
From approximately January 2006 through June 2011, Caring Nurse and Good Quality submitted approximately $48 million in claims for home health services that were not medically necessary and/or not provided. According to court documents, Medicare paid approximately $33 million for these fraudulent claims. At sentencing, scheduled for February 27, 2013, the owners each face a maximum penalty of 10 years in prison.
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