A federal jury in Miami has rendered convictions against a Florida man and woman for their involvement in a conspiracy to defraud Medicare by billing over $93 million for home health therapy services that were never provided.
Karel Felipe, 42, of Miami Shores, and Tamara Quicutis, 54, of Hialeah, were found guilty of conspiring with others to submit false bills to Medicare through three home health companies located in Michigan.
The scheme involved recruiting individuals from Cuba to sign Medicare enrollment documents and pose as owners of the home health agencies, concealing the identities of Felipe, Quicutis, and other participants.
Felipe, Quicutis, and their co-conspirators used these home health companies to submit claims for services that were never rendered, utilizing stolen patient identities.
The fraudulent proceeds were then laundered through hundreds of shell companies and bank accounts, ultimately converted into cash through Miami-area ATMs and check cashing stores.
During the trial, a third defendant, Jesus Trujillo, 52, of Miami, pleaded guilty to conspiring to commit health care fraud and wire fraud, as well as conspiring to commit money laundering.
Trujillo oversaw a group involved in recruiting nominee owners for home health agencies and shell companies and converting Medicare fraud proceeds into cash.
Felipe and Quicutis were convicted of conspiracy to commit health care fraud and wire fraud, as well as conspiracy to commit money laundering.
They are scheduled for sentencing on January 4, 2024, facing a maximum penalty of 20 years in prison for each conspiracy charge. Trujillo, set to be sentenced on December 21, also faces a maximum penalty of 20 years in prison for each count.
The FBI and the Department of Health and Human Services Office of the Inspector General (HHS-OIG) investigated the case. The U.S.
Sentencing Guidelines and other statutory factors will be considered by a federal district court judge in determining the sentences for the defendants.
Acting Assistant Attorney General Nicole M. Argentieri of the Justice Department’s Criminal Division, U.S. Attorney Markenzy Lapointe for the Southern District of Florida, Special Agent in Charge Jeffrey B. Veltri of the FBI Miami Field Office, and Special Agent in Charge Omar Pérez Aybar of HHS-OIG Miami Regional Office announced the convictions.
The case is being prosecuted by Trial Attorneys Jamie de Boer, D. Keith Clouser, and Emily Gurskis of the Criminal Division’s Fraud Section, with Assistant U.S. Attorney Gabrielle Charest-Turken for the Southern District of Florida handling asset forfeiture.
The Health Care Fraud Strike Force Program, led by the Fraud Section of the Criminal Division, is at the forefront of efforts to combat health care fraud.
Since March 2007, it has charged over 5,000 defendants who collectively have billed federal health care programs and private insurers more than $24 billion.
The Centers for Medicare & Medicaid Services, in collaboration with HHS-OIG, is also working to hold providers accountable for their involvement in health care fraud schemes.
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