MIAMI
A Florida man and woman were found guilty by a federal jury in Miami on Tuesday for their participation in a scheme to cheat Medicare by charging the agency for over $93 million in home health therapy services that were never provided, officials stated.
According to the evidence, Karel Felipe, 42, of Miami Shores, and Tamara Quicutis, 54, of Hialeah, collaborated with others to file fake Medicare claims for three Michigan-based home health agencies.
To hide the identity of Felipe, Quicutis, and other participants in the plan, their co-conspirators hired Cubans to sign Medicare registration paperwork and pose as the proprietors of the home health firms.
Felipe, Quicutis, and their co-conspirators used these home health companies to submit claims for services that were not rendered using lists of stolen patient identities.
Felipe, Quicutis, and their co-conspirators used hundreds of shell companies and bank accounts to launder the Medicare fraud proceeds and convert the proceeds into cash at Miami-area ATMs and check cashing stores.
After the trial commenced, a third defendant, Jesus Trujillo, 52, of Miami, pleaded guilty to one count of conspiring to commit health care fraud and wire fraud and one count of conspiring to commit money laundering, officials stated.
Trujillo oversaw a group of people that recruited nominee owners for home health agencies and shell companies and converted Medicare fraud proceeds into cash.
The jury convicted Felipe and Quicutis of conspiracy to commit healthcare fraud, wire fraud, and conspiracy to commit money laundering.
They are scheduled to be sentenced on Jan. 4, 2024, and they face a maximum penalty of 20 years in prison on each conspiracy charge.
Trujillo is scheduled to be sentenced on Dec. 21 and faces a maximum penalty of 20 years in prison on each count.
Trial Attorneys Jamie de Boer, D. Keith Clouser, and Emily Gurskis of the Criminal Division’s Fraud Section are prosecuting the case.
Assistant U.S. Attorney Gabrielle Charest-Turken for the Southern District of Florida is handling asset forfeiture.
The Fraud Section leads the Criminal Division’s efforts to combat health care fraud through the Health Care Fraud Strike Force Program. Since March 2007, this program, comprised of 15 strike forces operating in 25 federal districts, has charged more than 5,000 defendants who collectively have billed federal health care programs and private insurers more than $24 billion.
In addition, the Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, are taking steps to hold providers accountable for their involvement in health care fraud schemes. More information can be found at www.justice.gov/criminal-fraud/health-care-fraud-unit.