Largest National Medicare Fraud Takedown in History
TALLAHASSEE, Fla.—Florida Attorney General Pam Bondi joined federal authorities including the Federal Bureau of Investigation, the Department of Health and Human Services, the Office of Personnel Management and the Food and Drug Administration to announce the charges of 73 South Florida residents for their alleged participation in various schemes to defraud Medicare and Medicaid out of more than $262 million. The charges in South Florida are part of a nationwide takedown by Medicare Fraud Strike Force operations in 17 cities that resulted in charges against 243 individuals, including more than 46 doctors, nurses, and other licensed medical professionals, involving approximately $ 712 million in false billings. This coordinated takedown is the largest in strike force history, both in terms of the number of defendants and dollar amount.
“When you charge for a medical procedure you never performed, for something a patient never needed or asked for, and steal millions from our taxpayers, we are coming after you. I want to thank my Medicaid Fraud Control Unit and our federal partners who worked together through the Health Care Fraud Prevention and Enforcement Action Team, for the great investigative work that lead to these arrests,” said Attorney General Bondi. In one of the major cases, Attorney General Bondi’s Medicaid Fraud Control Unit investigated two Miami Lake residents for submitting false and fraudulent claims to Medicare and Florida Medicaid. According to the investigation, Odette Sanchez, 37, and Roque X. Garcia, 62, created false and fraudulent patient assessment forms stating unqualified Medicare and Medicaid beneficiaries were allowed to receive home health services. Sanchez and Garcia face charges of conspiracy to commit health care fraud and wire fraud and three counts of substantive health care fraud. Sanchez was the former owner of Limited Home Health Care, Inc., and Garcia was the former director of nursing for the company. Special Assistant U.S. Attorney Hagerenesh Simmons, from the Florida Attorney General MFCU, is prosecuting the case. Attorney General Bondi’s Medicaid Fraud Control Unit investigates and prosecutes fraud involving providers that intentionally defraud the state's Medicaid program through fraudulent billing practices. Medicaid fraud essentially steals from Florida's taxpayers. From January 2011 to March 2015, Attorney General Bondi's MFCU has obtained more than $474 million in settlements and judgments. Additionally, the MFCU investigates allegations of patient abuse, neglect, and exploitation in facilities receiving payments under the Medicaid program To learn more about HEAT, go to: StopMedicareFraud.gov. For more information on the cases involved in the national Medicare fraud takedown, click here. Related court documents and information may be found on the website of the District Court for the Southern District of Florida,here.