HCAF strongly condemns healthcare fraud and supports the removal of bad actors from the home health industry.
Nine residents of Miami-Dade County and a resident of Hillsborough County have been indicted for their alleged participation in a $12.5 million Medicare fraud scheme.
On March 20, 2014, a federal grand jury in Miami returned a 59-count indictment charging Vicente Diaz, 39, Daniel Ocampo, 35, Elsa Capo, 71, Santiago Sepulveda, 79, Marta Curbeco, 67, Margarita Rodriguez, 72, Francisco Maysonet, 67, Pedro Peralta, 69, Amira Galan, 79, and Ana Rosa Santana, 77, for allegedly participating in a scheme to defraud Medicare by submitting false and fraudulent claims, and the payment and receipt of kickbacks in connection with a federal health care program, from approximately November 2011 to October 2013.
The allegations center on the operation of Marcialed and Sacred Health, two companies located in Miami-Dade County which were purportedly in the business of providing home health care to Medicare beneficiaries.
According to the indictment, Diaz controlled Marcialed and Sacred Health. Ocampo was for a time an officer of Sacred Health. Diaz and Ocampo offered and paid kickbacks and bribes to patient recruiters in return for referring beneficiaries to serve as patients so that Marcialed and Sacred could bill Medicare for home health services that were not medically necessary and were not provided. Curbeco, Rodriguez and Peralta solicited and accepted kickbacks and bribes in exchange for referring beneficiaries to serve as patients of Marcialed and Sacred Health. Capo, Sepulveda, Curbeco, Rodriguez, Maysonet, Peralta, Galan, and Santana are Medicare beneficiaries who solicited and accepted kickbacks in return for agreeing to serve as patients of Maricaled and Sacred Health so that the companies could bill Medicare for home health services that were not medically necessary and were not provided.
The indictment alleges that the defendants falsified, and caused to be falsified, records to document the receipt of home health services from Marcialed and Sacred Health that were not provided and were not medically necessary. Diaz and Ocampo violated Medicare rules and regulations by offering and paying kickbacks and bribes to patient recruiters in exchange for the referral of beneficiaries to Marcialed and Sacred Health. Diaz and Ocampo then caused Marcialed and Sacred Health to submit false and fraudulent claims seeking payment from Medicare for the home health services which had purportedly been provided to beneficiaries, when in truth the services had not been provided and were not medically necessary. The indictment alleges that as a result of the fraudulent claims, Diaz and Ocampo caused Medicare to pay approximately $7,809,243 to Marcialed and $4,694,834 to Sacred Health.
The indictment alleges that Diaz, Ocampo and other conspirators used the money fraudulently obtained from Medicare for their personal use and to further the fraud. The indictment seeks forfeiture of two properties and four Mercedes vehicles.
Mr. Ferrer commended the investigative efforts of U.S. Postal Inspection Service, HHS-OIG, and the FBI and was brought as part of the Medicare Fraud Strike Force. This case is being prosecuted by Assistant U.S. Attorney Eric E. Morales.
An indictment is only an accusation, and a defendant is presumed innocent unless and until proven guilty.