Two Patient Recruiters of Miami HHA Plead Guilty in $20 Million Medicare Fraud Scheme

Two patient recruiters for a Miami home health care company have pleaded guilty for their participation in a $20 million home health Medicare fraud scheme. Manuel Lozano, 65, and Vladimir Jimenez, 43, pleaded guilty to one count each of conspiracy to receive health care kickbacks.

According to the court documents, both Lozano and Jimenez were patient recruiters who worked for Serendipity Home Health, a Miami home health care agency that claimed to provide home health and therapy services to Medicare beneficiaries.

The pair admitted that from approximately April 2007 through March 2009, Lozano and Jimenez would recruit patients, for which Serendipity could bill Medicare, in exchange for kickbacks and bribes they would solicit from Serendipity’s owners and operators. Medicare was billed for home health care and therapy services on behalf of these beneficiaries that were medically unnecessary and/or not provided.

Lozano and Jimenez each face a maximum potential penalty on the conspiracy charge of five years in prison and a $250,000 fine, or twice the gain or loss from the offense. Sentencing is scheduled for April 15 and April 1, 2013, for the respective defendants.

In a related case, on June 21, 2012, Serendipity owners and operators Ariel Rodriguez and Reynaldo Navarro were sentenced to 73 and 74 months in prison, respectively, following guilty pleas in March 2012 to one count each of conspiracy to commit health care fraud. According to court documents, from approximately January 2006 through March 2009, Serendipity submitted approximately $20 million in claims for home health services that were not medically necessary and/or not provided. Medicare actually paid approximately $14 million for these fraudulent claims.

Since their inception in March 2007, strike force operations in nine locations have charged more than 1,480 defendants who collectively have falsely billed the Medicare program for more than $4.8 billion. In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

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