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33 South Florida Residents Charged for Medicare Fraud

Thirty-three South Florida residents were charge with Medicare-related fraud in a recent indictment filed by federal prosecutors, a press release from the United States Attorney’s Office for the Southern District of Florida said Thursday. The arrests came after an anti-fraud operation carried out by the HHS Medicare Fraud Strike force and the Department of Justice. The suspects include doctors, nurses, and other professionals. They are accused of participating in a number of alleged schemes, including health care fraud, conspiracy to commit health care fraud, breaking anti-kickback acts, and money laundering. It is unclear if any arrests have been made. It is also unclear if any of the accused has hired a private criminal defense attorney.

Among those facing charges are Karen Kallen-Zury, Daisy Miller, Christian Coloma, Michele Petrie, and Gloria Himmons. Each defendant is charged with conspiracy to buy and obtain healthcare kickbacks and purchasing and acquiring kickbacks in association with a federal health care program. In addition, Zury, Miller, and Petrie are charged with devising and contributing to a scheme to offer unlawful bribes and kickbacks to patient advisors, as well as issuing claims to Medicare recipients who were obtained using bribes and kickbacks.

Reports say Zury worked as the chief officer of Hollywood Pavilion between 2003 and 2012. During that time, the organization allegedly covered up the use of illegal kickbacks to make it look like the business was offering genuine medical services. The company received an excess of $50 million from Medicare for patients who were coerced into receiving treatment through bribes or who were not eligible for the services they were being given, reports say.

A civil case filed alongside of the charges put a lock on Zury’s personal funds, reports indicate. The temporary lock is intended to prevent the spending of money that may be refunded to Medicare following a trial.

Others facing charges in this recent sting are Rogelio Rodriguez and Raymond Aday. Each is charged with conspiracy to fund and receive health care kickbacks and conspiracy to commit health care fraud. According to reports, Rodriguez owned and ran a company called Caring Nurse Home Health Corp. out of South Florida, for which Aday worked as a patient recruiter. Aday owned another business called Good Quality Home Health Inc. (Rodriquez was a part owner of that business as well). Officials believe both companies were involved in the fraud. In all, detectives accuse the two defendants of fraudulently charging Medicare for $53 million, of which their businesses received $34 million.

Reports say that the pair, through their companies, offered bribes and kickbacks to patient recruiters for the procurement of Medicare-eligible patients. Once the businesses acquired Medicare users, they purportedly filed fraudulent reports to Medicare, charging for specially trained nurses who offered daily insulin injections to patients.

The list does not end there. Sila Luis, Elsa Ruiz, and Myriam Acevedo were also accused of similar charges of conspiracy to bribe and offer unlawful kickbacks and conspiracy to commit health care fraud. Reports say Luis owned and ran the company, LTC Professional Consultants Inc., through which he offered employees illegal kickbacks for the procurement of Medicare-eligible patients. The indictment also accuses the company of filing for fraudulent submission to Medicare. Reports say Ruiz owned another business, Professional Home Care Solutions, Inc., which offered similar fraudulent activity as LTC Professional Consultants Inc. The indictment alleges that Ruiz offered unlawful bribes and debated the prices of those bribes with the company’s employees.

Sources indicated Acevedo as an agency supervisor for both Sila and Ruiz’s businesses. Part of Acevedo’s alleged duties were discussing and deciding on the amount money that each kickback paid the employees of both organizations. In all, the group is accused of filing for more than $70 million in falsified Medicare reimbursement, of which both of their companies received $50 million.

The release also indicated the following suspects for health-care related fraud: Vladimir Jimenez, Manuel Lozano, Orlando J. Torres, Remberto Lago Valdes, Alina Alvarez, Angel Calderin, Yanella Falcon, Pedro Guzman, Jose Manuel Curiel, Liset Curiel Fages, Alfredo Gonzalez, Guillermo Blanco, Yanier Betancourt, Maria Eugenia Rueda, Jorge Sell, Arminda Reyes, Rene Suarez-Basanta, Maria Esther Valdez, Manuela Edelia Rodriguez, Francisco A. Rizo, Cristobal Jorge Garcia, and Marta Gonzalez.

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