Patient recruiter pleads guilty to $870,000 kickback scheme | Takeover bid

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A Florida man pleaded guilty today in the Southern District of Florida to a scheme to receive kickbacks and kickbacks in exchange for referring Medicare beneficiaries to five agencies of South Florida Home Health for services that patients did not need and, in many cases, never received.

Ernesto Espinosa, 71, of Miami, pleaded guilty to one count of conspiracy to commit health care fraud. According to court documents, from January 2010 to June 2015, Espinosa and his co-conspirators bribed Medicare beneficiaries to recruit and refer them to home health agencies. Espinosa also trained Medicare beneficiaries, who did not need home health services, on what to say to get home medical prescriptions from doctors. In return for recommending these recipients, Espinosa solicited and received bribes and kickbacks from home health agencies. Espinosa and home health agencies attempted to cover up these bribes and kickbacks by passing them through shell companies controlled by Espinosa. Home health agencies then submitted false and fraudulent claims to Medicare for services that were not medically necessary and usually not even provided. As a result of this fraud, Espinosa and his co-conspirators compelled Medicare to make payments of approximately $870,000 for the false claims. Espinosa personally withdrew approximately $630,000 from the program.

Espinosa is due to be sentenced on May 24 and faces up to 10 years in prison. A federal district court judge will determine any sentence after considering US sentencing guidelines and other statutory factors.

Assistant Attorney General Kenneth A. Polite Jr. of the Justice Department’s Criminal Division; Special Agent in Charge Omar Pérez Aybar of the Department of Health and Human Services, Office of the Inspector General (HHS-OIG), Miami Regional Office; Deputy Director Luis Quesada of the FBI’s Criminal Investigations Division; and Special Agent in Charge George L. Piro of the FBI Miami Field Office made the announcement.

The FBI and HHS-OIG investigated the case.

Trial prosecutors Kelly M. Lyons, Alexander Thor Pogozelski and Jamie De Boer of the Justice Department’s Fraud Section prosecuted the case.

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