Seventy-Seven Charged in Southern District of Florida as Part of Largest Health Care Fraud Action in Department of Justice History

MIAMI, Fla., July 13 -- The Acting U.S. Attorney for the Southern District of Florida, Benjamin G. Greenberg, issued the following news release:

Benjamin G. Greenberg, Acting United States Attorney for the Southern District of Florida; George L. Piro, Special Agent in Charge, Federal Bureau of Investigation (FBI), Miami Field Office; Shimon R. Richmond, Special Agent in Charge, U.S. Department of Health & Human Services, Miami Regional Office, Office of Inspector General (HHS-OIG); and Pam Bondi, Florida Attorney General; announced today the largest ever health care fraud enforcement action by the Medicare Fraud Strike Force, involving 412 charged defendants across 41 federal districts, including 115 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $1.3 billion in false billings. In the Southern District of Florida a total of 77 defendants were charged with offenses relating to their participation in various fraud schemes involving over $141 million in false billings for services including home health care, mental health services and pharmacy fraud.

Acting U.S. Attorney Benjamin G. Greenberg said, "Health care fraud schemes have real, long-term consequences for our South Florida community. Patients are being denied the quality of care that they deserve, doctors are turning a blind eye to their oaths, and taxpayer money is being diverted into the pockets of the greedy. Today's announcement highlights South Florida's united and ongoing law enforcement effort, culminating in charges against more than twenty percent of the national defendants, to thwart evolving schemes and combat the unlawful distribution of opioids and prescriptions drugs.

"The number of arrests are staggering and the dollar losses immense," said Tim Langan, Acting Special Agent in Charge, FBI Miami. "These health care fraudsters, driven by greed, sought to cheat their way to riches by bilking millions of dollars from Medicare and other health care programs. The victims are U.S. taxpayers. The FBI and our law enforcement partners will investigate and criminally prosecute such fraud to the fullest extent of the law."

"Those who betray patients and commit health care fraud by either distributing or receiving thinly veiled bribes, steal from taxpayers and corrupt the integrity of our health care system," said Special Agent in Charge Shimon R. Richmond, HHS OIG Miami. "This takedown reflects the dedication of OIG and our law enforcement partners to bring such fraudsters to justice."

Florida Attorney General Pam Bondi stated, "This massive fraud takedown targeted people abusing our health care industry and, in some cases, profiting from patients trying to recover from opioid addiction. The arrests and recoveries announced today should serve as a warning to anyone scheming to commit health care fraud that we will find them and they will be held accountable."

The following are some of the cases included in the takedown:

SOBER HOMES FRAUD

1. United States v. Eric Snyder and Christopher Fuller, Case No 17-MJ-8268-Brannon

Eric Snyder, 30, of Delray Beach, Florida, an owner of sober homes and addiction treatment facilities, and patient broker Christopher Fuller, 32, of West Palm Beach, Florida, are charged in a criminal complaint with conspiracy to commit health care fraud for their involvement in a scheme to illegally recruit patients, pay kickbacks and defraud health care benefit programs.

According to the criminal complaint, Snyder established a sober home, Halfway There Florida, LLC (HWT), also known as A Safe Place LLC, in Palm Beach County, Florida, which was purportedly in the business of providing a safe and drug-free residence for individuals suffering from drug and alcohol addiction. The defendants referred the sober home's residents to a treatment center, Real Life Recovery Delray, LLC, (RLR), which was also owned by Eric Snyder. This treatment center purportedly offered clinical treatment services for persons suffering from alcohol and drug addiction.

According to the criminal complaint, to obtain patients for the sober home and treatment center (collectively "HWT/RLR"), Synder and other members of the conspiracy provided kickbacks and bribes, in the form of free or reduced rent, airline tickets, and other benefits, to individuals who agreed to reside at the sober homes, attend drug treatment therapy sessions, and submit to regular drug testing that members of the conspiracy could bill to the residents' insurance plans. These patient brokers, including Fuller, were also paid kickbacks themselves by Snyder and others for referring patients to HWT/RLR for purported treatment.

According to the criminal complaint, fraudulent billings were submitted by HWT/RLR for services that were not medically necessary and/or were never provided. Licensed health professionals who used to work at HWT/RLR describe treatment conducted by unqualified and non-licensed employees, and billings for treatment that never occurred. The licensed professionals were asked to sign for and/or backdate this treatment as though they had conducted it. In addition, licensed professionals at HWT/RLR were asked to complete intake forms and other documents for patients that they had not seen. In some instances, services were billed for residents who left the sober homes and were no longer receiving treatment at the treatment centers. In other instances, patients were billed for therapy sessions they never attended, and therapy sign-in sheets and other documents fraudulently reflected that these patients attended these sessions, when they did not. The defendants provided services meant solely to maximize insurance reimbursements, such as expensive urine drug screens. HWT/RLR fraudulently used urine drug screens as a profit-machine, including splitting samples to send them to different laboratories, improper duplicate testing, and fraudulently double billing for tests for the same patients at both HWT and RLR. In addition, samples were fraudulently comingled prior to testing to prevent identical test results from exposing the scheme. After a search warrant was executed at a different treatment facility in Palm Beach County, in September 2014, Snyder and others attempted to stop or modify these illegal practices, and evidence of this wrongful conduct was removed and destroyed.

Mr. Greenberg commends the investigative efforts of the Greater Palm Beach County Health Care Fraud Task Force. Agencies of the task force that assisted with this matter include the FBI, Internal Revenue Service, Criminal Investigation (IRS-CI), Amtrak Office of Inspector General (Amtrak-OIG), U.S. Department of Labor Employee Benefits Security Administration (DOL), U.S. Office of Personnel Management Office of Inspector General (OPM-OIG), Palm Beach County State Attorney's Office Sober Home Task Force, Palm Beach County Sheriff's Office, Delray Beach Police Department, Martin County Sheriff's Office and the National Insurance Crime Bureau (NICB). The case is being prosecuted by Assistant United States Attorney James V. Hayes.

DRUG AND PHARMACY FRAUD SCHEMES - Medicare Part D

2. United States v. Orlando Bustabad, et al., Case No. 17-20441-CR-Moore

Orlando Bustabad, 61, Orlando Olver Bustabad, 31, Idilsis Manresa, 30, Sara Fernandez Escobar, 61, Mirtha Carrion Jimenez, 58, Alejandro Mena, 21, and Alejandro Sierra, 47, all of Miami, Florida, are charged by indictment with conspiracy to commit health care fraud and health care fraud. Orlando Bustabad and Orlando Olver Bustabad are also charged with aggravated identity theft.

According to the indictment, Orlando Bustabad and his son Orlando Olver Bustabad were the true owners of eight pharmacies located in Miami Dade County, namely, Med Solution Pharmacy, 17th Street Pharmacy, Rapid Pharmacy, Euro Pharmacy, A&B Pharmacy, Maxi Pharmacy, Mariposa Pharmacy, and 49th Street Pharmacy. Orlando Bustabad and Orlando Olver Bustabad operated these pharmacies under their own names or enlisted co-conspirators Manresa, Escobar, Jimenez, Mena, and Sierra to appear as owners. These pharmacies purportedly provided prescription drugs to Medicare beneficiaries. From February 2013 until June 2017, the defendants submitted and caused the submission of approximately $10,183,031 in claims for reimbursement to the Medicare Part D program, via interstate wires, that falsely and fraudulently represented that various health care benefits, primarily prescription drugs, were medically necessary, prescribed by a doctor, and had been provided by the pharmacies. As a result of such false and fraudulent claims, Medicare prescription drug plan sponsors made payments funded by the Medicare Part D Program to the corporate bank accounts of the eight pharmacies in the approximate amount of $4,649,743.

Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. This case is being prosecuted by Assistant United States Attorney Christopher J. Clark.

3. United States v. Victor Rocha, Case No. 17-20409-CR-Altonaga

Victor Rocha, 49, of Miami Lakes, Florida, was charged by indictment with six counts of health care fraud. The indictment charges Rocha with falsely and fraudulently submitting medical claims for prescription medications for reimbursement to Medicare Part D from September 2012 through May 2013, through his pharmacy, Med Express Pharmacy Discount, Inc. The Indictment charges that the claims were for prescription medications that were not provided and/or not medically necessary.

Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. This case is being prosecuted by Assistant U.S. Attorney James V. Hayes.

4. United States v. Alejandro Hernandez Rios, Case No. 17-20442-CR-Ungaro

Alejandro Hernandez Rios, 35, of Miami, Florida, was charged by indictment with five counts of health care fraud. The indictment charges Rios with falsely and fraudulently submitting medical claims for prescription medications for reimbursement to Medicare Part D from June through September 2014, through his pharmacy Independence Pharmacy and Discount, Inc. The indictment charges that the claims were for various prescription medications that were not provided and/or not medically necessary.

Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. This case is being prosecuted by Assistant U.S. Attorney James V. Hayes.

5. United States v. Pedro Mangano, Case No. 17-20408-CR-Martinez

Pedro Mangano, 52, of Miami, Florida, was charged by indictment with ten counts of Medicare fraud. The indictment alleges Mangano was the owner and operator of PVRX Pharmacy, located in Miami, Florida. Between March 2014 and June 2017, Mangano's pharmacy submitted fraudulent claims for allegedly dispensing drugs to Medicare beneficiaries that the pharmacy never had in inventory to begin with. As part of the scheme, Mangano paid patient recruiters for fraudulent scripts used to defraud the Medicare Part D program. The fraudulent claims resulted in overpayments exceeding $1.1 million.

Mr. Greenberg commends the investigative efforts of HHS-OIG. This case is being prosecuted by Assistant United States Attorney Jon Juenger.

6. United States v. William Salazar Ortega, et al., Case No. 17-20454-CR-Gayles

On June 28, 2017, William Salazar Ortega and Oscar Alonso Gonzalez were indicted in connection with their roles at Latin Pharmacy, a pharmacy that defrauded Part D of the Medicare program of $2.38 million by billing for expensive prescription medications that were not prescribed to patients; were not necessary; and were not purchased. Salazar was the nominee owner of the pharmacy, and Gonzalez was its true owner. Each defendant was charged with one count of conspiracy to commit health care fraud and wire fraud and four counts of health care fraud. Gonzalez is also charged with one count of money laundering.

Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. The case is being prosecuted by Fraud Section Trial Attorney Timothy Loper.

7. United States v. Yara Suarez, et al., Case No. 17-20453-CR-Moreno

On June 29, 2017, Yara Suarez, Jesus Sanchez, Anthony Moya and Yoel Concepcion were indicted in connection with their roles at Albe Pharmacy, a pharmacy that defrauded Part D of the Medicare program of $3.4 million by billing for expensive prescription medications that were not prescribed to patients; were not necessary; and were not purchased. Sanchez and Suarez were the owners of the pharmacy, and are each charged with one count of conspiracy to commit health care fraud and wire fraud, three counts of health care fraud and one count of conspiracy to commit money laundering. Moya and Concepcion owned and controlled shell corporations through which over $380,000 of the fraud proceeds were laundered. Moya and Concepcion are each charged with one count of conspiracy to commit money laundering and three counts of substantive money laundering.

Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. The case is being prosecuted by Fraud Section Trial Attorney Timothy Loper.

8. United States v. Lisbet Cordova, Case No. 17-20450-CR-Cooke

On June 29, 2017, Lisbet Cordova, the owner of Jalvarez Pharmacy, Inc. ("Jalvarez") was indicted on four counts of health care fraud. Through Jalvarez, Cordova billed Medicare, pursuant to Part D of the Medicare program, for prescriptions that were not medically necessary, prescribed or dispensed to Medicare beneficiaries. As part of the scheme, Jalvarez submitted approximately $730,000 in fraudulent claims to Medicare.

Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. The case is being prosecuted by Fraud Section Attorneys Alexander Kramer and Yisel Valdes.

PRESCRIPTION DRUG DIVERSION

9. United States v. Jose De Jesus Rodriguez, Case No. 17-20486-CR-Scola

Jose De Jesus Rodriguez, 47, of Miami, Florida, was charged by indictment with one count of conspiracy to unlawfully distribute prescription drugs and three substantive counts of improperly distributing prescription drugs, also referred to as prescription drug diversion. The indictment charges Rodriguez with illegally distributing millions of dollars' worth of prescription medications from August 2011 through March 2015.

Mr. Greenberg commends the investigative efforts of the U.S. Food and Drug Administration's (FDA) Office of Criminal Investigations (OCI), and HHS-OIG. This case is being prosecuted by Assistant U.S. Attorney James V. Hayes.

10. United States v. Reynaldo Ocana, Case No. 17-MJ-02939-Otazo-Reyes

Reynaldo Ocana, 46, of Miami, Florida, was charged by criminal complaint with improperly distributing prescription drugs, also referred to as prescription drug diversion. The criminal complaint charges Ocana with illegally diverting prescription drugs in August 2016.

Mr. Greenberg commends the investigative efforts of HHS-OIG. This case is being prosecuted by Assistant U.S. Attorney James V. Hayes.

HOME HEALTH CARE FRAUD - Medicare Part A

11. United States v. Hector Fajardo Ramirez, Case No. 17-20301-CR-Moreno

Hector Fajardo Ramirez, 48, of Miami, Florida, was charged by indictment with six counts of health care fraud. The indictment charges that Ramirez falsely and fraudulently submitted medical claims for home health therapy for reimbursement to Medicare from February through July 2015, through his clinic Longevity Home Health Services, Inc. The indictment charges Ramirez with submitting claims for home health services that were not medically necessary and not provided.

Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. This case is being prosecuted by Assistant U.S. Attorney James V. Hayes.

12. United States v. Duniesky Cruz and Carlos Gomez Bravo, Case No. 17-20401-CR-Scola

Duniesky Cruz, 50, of Miami, Florida, the owner of home health agency Life & Hope Healthcare, Inc., and an employee Carlos Gomez Bravo, 33, of Miami, Florida, were charged by indictment with conspiracy to defraud the United States and pay health care kickbacks and payment of kickbacks in connection with a federal health care program. The charges stem from their involvement in a home health fraud scheme involving kickback payments to patient recruiters, patients, and clinic owners in exchange for patient referrals and prescriptions.

Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. This case is being prosecuted by Assistant United States Attorney Michael E. Gilfarb.

13. United States v. Vilma Alonso, Case No. 17-20468-CR-Ungaro

Vilma Alonso, 57, of Hialeah, Florida, an employee of South Florida Physician Care Network was charged by indictment with participating in a conspiracy to defraud the United States. Alonso was charged with conspiring with others to unlawfully enrich themselves by, among other things, submitting and causing the submission of false and fraudulent claims to Medicare and concealing the submission of false and fraudulent claims to Medicare. Alonso allegedly did this by causing the issuance of home health prescriptions that were not medical necessary and by paying recruiters for the referral of Medicare beneficiaries for home health services.

Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. This case is being prosecuted by Assistant United States Attorney Michael E. Gilfarb.

14. United States v. Maria Blanco, Case No. 17-20474-CR-Williams

Maria Blanco, 50 of Cape Coral, Florida, was charged by information with five counts of receiving kickbacks in connection with a federal health care program. The information charges Blanco with receiving approximately $8,500 in kickbacks on at least five occasions in 2014.

Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. This case is being prosecuted by Assistant U.S. Attorney Michael B. Nadler.

15. United States v. Enrique Vilarello, et al., Case No. 17-20482-CR-Williams

On July 7, 2017, Enrique Vilarello and Alberto Ordaz were each indicted on one count of conspiracy to pay and receive illegal kickbacks. Ordaz was also indicted on two counts of receipt of kickbacks in connection with a federal health care program. The charges stem from their roles as patient recruiters, paying illegal kickbacks to obtain medical prescriptions from clinics and receiving illegal bribes for referring patients to pharmacies, and home health agencies in and around Miami, Florida. Several of these entities, such as Merfi and City Center, are now defunct as a result of their owners being charged and pleading guilty to multi-million dollar fraud schemes.

Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. The case is being prosecuted by Trial Attorney Angela Adams.

16. United States v. Juan Rodriguez, Case No. 17-20347-CR-Scola

On May 25, 2017, Juan Rodriguez, President and Director of Good Home Care, Inc., a now-defunct home health agency located in Miami, Florida, was indicted on five counts of health care fraud for his role in a $4 million scheme. Good Home allegedly billed Medicare for home health services that were never prescribed by a licensed physician or provided to Medicare beneficiaries.

Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. The case is being prosecuted by Trial Attorney David Snider.

17. United States v. Jesus Escobar Montero, Case No. 17-20439-CR-Williams

On June 22, 2017, Jesus Escobar Montero, President and Director of Better Care Home Health Services, Inc., a now-defunct home health agency located in Sunrise, Florida, was indicted on four counts of health care fraud for his role in a nearly $1 million scheme. The charges arise from Montero's ownership of Better Care, which billed Medicare for home health services that were never prescribed by a licensed physician or provided to Medicare beneficiaries.

Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. The case is being prosecuted by Trial Attorney David Snider.

18. United States v. Carlos Barroso, et al., Case No. 17-20432-CR-Martinez

On June 22, 2017, Carlos Barroso, Andres Perez, Rolando Perez and Reiniel Garcia were indicted in connection with their roles at Sweet Home Health, Inc., a home health agency that defrauded Part A of the Medicare program of $8.4 million by billing for home health services that were not prescribed to patients; were not necessary; and were not rendered. Barroso was the owner of Sweet Home Health and was charged with seven counts of health care fraud, as well as one count of conspiracy to commit money laundering. A. Perez, R. Perez and Garcia owned and controlled shell corporations through which the fraud proceeds were laundered. They are each charged with one count of conspiracy to commit money laundering, three counts of money laundering and three counts of structuring to avoid reporting requirements.

Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. The case is being prosecuted by Fraud Section Trial Attorney Timothy Loper.

19. United States v. Jhony A. Alfau, et al, Case No. 17-20452-CR-Ungaro

On June 29, 2017, Jhony A. Alfau, Hector J. Garcia, and Sergio E. Santana were indicted on one count of conspiracy to commit health care and wire fraud, one count of conspiracy to make false statements relating to health care matters, and one count of making false statements relating to health care matters.The charges stem from the defendants' role in a $50 million scheme to defraud Medicare where they falsely and fraudulently certified they provided home health care physical and occupational therapy services to Medicare beneficiaries, when in fact, they had not done so.

Mr. Greenberg commends the investigative assistance of the FBI and HHS-OIG. This case is being prosecuted by Fraud Section Attorneys Yisel Valdes and Alexander Kramer.

20. United States v. Ernesto Velasquez, Case No. 17-20462-CR-Martinez

On July 5, 2017, Ernesto Velasquez, was charged by information with one count of conspiracy to commit health care fraud. The charge stems from the defendant's role as an employee of staffing agencies that sought to defraud the United States by billing Medicare for providing licensed physical and occupational therapy to home bound patients when, in fact, they had not rendered the services. As part of the scheme, these alleged services were billed to Medicare with a loss of over $3 million.

Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. The case is being prosecuted by Fraud Section Attorneys Alexander Kramer and Yisel Valdes.

21. United States v. Suley Cao, Case No. 17-20451-CR-Martinez

On June 29, 2017, Suley Cao, the owner and operator of Good Friends Services, Inc. ("Good Friends"), a home health agency, was indicted on five counts of health care fraud; one count of conspiracy to defraud the United States and pay Health Care Kickbacks; and two counts of payment of kickbacks in connection with a federal health care benefit program. The charges stem from Cao's role as owner and operator of Good Friends, which fraudulently billed Medicare for approximately $3,017,276.89 for home health services that involved a scheme whereby Good Friends made kickback payments to induce the referral of Medicare beneficiaries.

Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. The case is being prosecuted by Fraud Section Attorneys Alexander Kramer and Yisel Valdes.

22. United States v. Rafael Arias et al., Case No. 17-MJ-02962-Garber

On July 13, 2017, Rafael Arias, Aylen Gonzalez, Ana Gabriela Mursuli Caballero, and Rafael Cabrera were charged by criminal complaint with conspiracy to commit health care fraud for their roles in an approximately $6 million Medicare fraud scheme involving various home health agencies in and around Miami, Florida. Arias was alleged to be the true owner of multiple home health agencies, such as Nestor's Health Services, Inc. Arias hid the fact of his true ownership and instead directed others, like Cabrera, to fraudulently represent themselves as owners to Medicare, which allowed them to obtain Medicare provider numbers and submit claims for services purportedly provided to Medicare beneficiaries even though many of the services were medically unnecessary or were obtained as a result of illegal bribes and kickbacks. Gonzalez and Caballero were patient recruiters who facilitated kickback schemes with Arias by referring patients to home health agencies operated by Arias in exchange for bribes and kickbacks. Gonzalez and Caballero also purchased medically unnecessary prescriptions from fraudulent medical clinics. Caballero also owned and operated City of Angels Home Health Care LLC, a home health agency that she used to bill Medicare for home health services that were medically unnecessary or were obtained as a result of illegal bribes and kickbacks.

Mr. Greenberg commends the investigative efforts of the FBI. The case is being prosecuted by Fraud Section Trial Attorney Angela Adams.

ASSISTED LIVING FACILITY FRAUD

23. United States v. Bertha Blanco, Case No. 17-MJ-02949-Garber

On July 11, 2017, Bertha Blanco, who was employed for approximately 30 years by the State of Florida's Agency for Health Care Administration (AHCA), was charged by complaint with bribery of a program receiving federal funds. AHCA is responsible for administering the Medicaid program in Florida, and is tasked with regulating and licensing health care facilities in Florida, including skilled nursing facilities (SNFs) and assisted living facilities (ALFs). The charge alleges that Blanco solicited and received cash bribes from Medicare and Medicaid providers in exchange for providing them with confidential, nonpublic AHCA reports and information, including patient complaints and the unannounced inspection schedules of AHCA surveyors. This information was ultimately used by the purchasers, some of whom were owners of skilled nursing facilities (SNFs) and assisted living facilities (ALFs), to fabricate and falsify medical paperwork and to temporarily remedy deficiencies so that AHCA would not discover lapses in patient care and revoke the licenses of these facilities. The owners of these SNFs and ALFs then submitted false and fraudulent claims to Medicare and Medicaid for patients named in the complaints and inspection reports sold to them by Blanco.

Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. This case is being handled by Trial Attorneys David Snider, Elizabeth Young and Drew Bradylyons.

CLINICS, MANAGED CARE, MEDICARE ADVANTAGE FRAUD -

Medicare Part C

24. United States v. Beatriz Carrasco, Case No. 17-20464-CR-Ungaro

On July 6, 2017, Beatriz Carrasco, 49, of Hialeah, Florida was charged by information with one count of conspiracy to commit health care fraud and wire fraud. The information charges Carrasco, a Florida licensed insurance agent, with conspiring to enroll others into Medicare Advantage plans and Florida Medicaid. These individuals resided in Nicaragua, outside of the Medicare Advantage plans coverage area. As a result of Carrasco's and her co-conspirator's actions, Medicare and the Florida Medicaid program paid over $1,013,244 in monthly capitation payments and premiums on behalf of individuals residing in Nicaragua, who were otherwise ineligible to receive these benefits.

Mr. Greenberg commends the investigative efforts of the FBI, HHS-OIG and the State of Florida Medicaid Fraud Control Unit. This case is being prosecuted by Special Assistant U.S. Attorney Hagerenesh Simmons from the Florida Attorney General's Office, Medicaid Fraud Control Unit.

25. United States v. Greesy Misuraca, Case No. 17-20461-CR-Scola

On July 5, 2017, Greesy Misuraca, a licensed therapist, was charged by information with one count of conspiracy to commit health care fraud. The charge stems from the defendant's alleged role in billing Medicare for licensed physical and occupational therapy that was given to home bound patients when, in fact, she did not provide the therapeutic services. As part of the scheme, these alleged services were billed to Medicare with a loss of over $650,000.

Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. The case is being prosecuted by Fraud Section Attorneys Alexander Kramer and Yisel Valdes.

PRIVATE INSURANCE FRAUD (Non-Medicare)

26. United States v. Leopoldo Becerra, Case No. 17-20470-CR-Moreno

Leopoldo Becerra, 50, of Miami, Florida was charged by indictment one count of health care fraud. The indictment charges Becerra with using Doctor Jalal Taslimi Medical Center, Inc., to falsely and fraudulently submit medical claims for reimbursement to Blue Cross Blue Shield of Florida from November 25, 2014 through May 25, 2015. The indictment charges Becerra with submitting fraudulent claims for beneficiaries purportedly receiving various injections.

Mr. Greenberg commends the investigative efforts of the FBI. This case is being prosecuted by Assistant U.S. Attorney Michael B. Nadler.

27. United States v. Jorge A. Gonzalez and Lazaro La Paz Paz,

Case No. 17-20440-CR-Martinez

Jorge A. Gonzalez, 50, of Miami, Florida and Lazaro La Paz Paz, 50, of Hialeah, Florida are charged by indictment with one count of conspiracy to commit health care fraud and wire fraud. The indictment charges Gonzalez and La Paz Paz with using two companies, Xtra Health Center, Inc & Gold Medical Center, Inc, and fraudulently representing that medical services were prescribed by doctors and provided to private insurance beneficiaries by these businesses. Gonzalez and La Paz Paz then falsely and fraudulently submitted these medical claims for reimbursement to Blue Cross Blue Shield of Florida from April 2014 through February 2015.

Mr. Greenberg commends the investigative efforts of the FBI. This case is being prosecuted by Assistant U.S. Attorney Michael B. Nadler.

TRICARE FRAUD - Military Insurance

28. United States v. Michael Shane Matthews, Case No. 17-20463-CR-Gayles

On July 6, 2017, Michael Shane Matthews, 47, of Newberry, Florida, was charged by information with causing the misbranding of drugs while held for sale.

Mr. Greenberg commends the investigative efforts of Defense Criminal Investigative Service (DCIS), Southeast Field Office, U.S. Food and Drug Administration's (FDA) Office of Criminal Investigations (OCI), the U.S. Army Criminal Investigation Command's Major Procurement Fraud Unit, and HHS-OIG. This case is being prosecuted by Assistant United States Attorney Kevin J. Larsen.

29. United States v. Asciano Serna, Case No. 17-20484-CR-Altonaga

On July 7, 2017, Asciano Serna, owner and operator of ASC Pharmacy, Inc., was charged by information with one count of conspiracy to commit health care fraud. The charge arises from Serna's role in a compounding pharmacy scheme at ASC Pharmacy involving the submission of at least $3.4 million of false and fraudulent claims to private insurance companies, Medicare, TRICARE, and other federal programs.

Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. This case is being prosecuted by Assistant United States Attorney Jon Juenger and Trial Attorney David Snider.

UNLICENSED MONEY TRANSMITTING AND MONEY LAUNDERING

30. United States v. Yisel Torres, Case No. 17-20477-CR-Moreno

Yisel Torres, 31, of Cape Coral, Florida was charged by information with one count of participating as an unlicensed money transmitter. The information charges Torres with cashing several checks totaling $135,000 from on or about May 22, 2014, through on or about March 11, 2015. The proceeds that Torres cashed were used to pay cash kickbacks to Medicare beneficiaries that were enrolled in R&N Professional Services.

Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. This case is being prosecuted by Assistant U.S. Attorney Michael B. Nadler.

31. United States v. Angel Rivero, Case No. 17-20475-CR-Cooke

Angel Rivero, 43, of Miami, Florida was charged by information with one count of participating as an unlicensed money transmitter. The information charges Rivero with cashing several checks totaling $100,000 from on or about May 22, 2014, through on or about March 11, 2015. The proceeds that Rivero cashed were used to pay cash kickbacks to Medicare beneficiaries that were enrolled in Happy Heart Home Health Care.

Mr. Greenberg commends the investigative efforts of the FBI and HHS-OIG. This case is being prosecuted by Assistant U.S. Attorney Michael B. Nadler.

32. United States v. Yailyn Marimon, et al., Case No. 17-20492-CR-Martinez

On July 11, 2017, Yailyn Marimon and Yamilka Echeverria were indicted in connection with their roles laundering money four Orlando-area medical clinics stole from Part C of the Medicare program. The Clinics, which were owned by Yosbel Marimon - the defendants' brother and ex-husband, respectively - billed Medicare for $13.8 million of expensive infusion therapy drugs and physical therapy that were not medically necessary, and were never provided. On June 26, 2017, Yosbel Marimon was sentenced to 90 months' imprisonment for his role in the scheme. The indictment alleges that Yailyn Marimon and Yamilka Echeverria laundered over $2 million of the fraud proceeds through shell companies they owned and controlled. Each defendant was charged with one count of conspiracy to commit money laundering and one count of substantive money laundering.

Mr. Greenberg commends the investigative efforts of HHS-OIG. The case is being prosecuted by Fraud Section Trial Attorney Timothy Loper.

If convicted of a charged offense, a defendant faces a possible maximum statutory sentence of: five years in prison for participating in a conspiracy (to defraud the United States by paying and receiving health care kickbacks or by unlawfully distributing prescription drugs), in violation of Title 18, United States Code, Section 371; twenty years in prison for mail fraud, in violation of Title 18, United States Code, Section 1341; twenty years in prison for wire fraud, in violation of Title 18, United States Code, Section 1343; ten years in prison for health care fraud, in violation of Title 18, United States Code, Section 1347; twenty years for conspiracy to commit health care fraud and wire fraud, in violation of Title 18, United States Code, Section 1349; twenty years for money laundering or conspiracy to commit money laundering, in violation of Title 18, United States Code, Section 1956; and ten years in prison for money laundering, in violation of Title 18, United States Code, Section 1957; and five years in prison for conducting an unlicensed money transmitting business, in violation of Title 18, United States Code, Section 1960(b)(2). In addition, a defendant may be subject to one year in prison for misbranding a drug held for sale, in violation of Title 21, United States Code, Sections 331(t) (prescription drug marketing violations are subject to a maximum penalty of ten years in prison, in accordance with Title 21, United States Code, Sections 333(b)(1)(D), and 353(e)(1)(A)) and five years in prison for payment and receipt of kickbacks in connection with a federal health care program, in violation of Title 42, United States Code, Section 1320a. Furthermore, if convicted of aggravated identity theft, in violation of Title 18, United States Code, Section 1028A, a defendant faces a mandatory consecutive term of two years in prison.

A criminal complaint, information or federal indictment is a charging instrument containing allegations. All defendants are presumed innocent, unless and until proven guilty in a court of law.

Related court documents and information may be found on the website of the District Court for the Southern District of Florida at www.flsd.uscourts.gov or on http://pacer.flsd.uscourts.gov.