FLORIDA – Four South Florida residents were sentenced Thursday in connection with a long-running $6.2 million Medicare fraud scheme involving Professional Medical Home Health LLC, a Miami home health care agency, federal prosecutors said.
Professional Home Health maintained that they provided home health and therapy services, authorities maintain.
Two of the defendants were also sentenced in connection with their conduct in similar schemes at other Miami home health care agencies.
The four got the following sentences:
Dennis Hernandez, 32, of Miami, was sentenced to serve 12 years in prison and ordered to pay $1,4 million in restitution.
Jose Alvarez, 48, of Miami, was sentenced to serve 12 years in prison and ordered to pay $2.9 million in restitution.
Joel San Pedro, 45, of Miami, was sentenced to serve a year and a month in prison and ordered to pay $4,9 million in restitution.
Alina Hernandez, 38, of West Palm Beach, was sentenced to serve two years in prison and ordered to pay $204,526 in restitution.
Dennis Hernandez, Alvarez, San Pedro and Alina Hernandez each pleaded guilty to one count of conspiracy to commit health care fraud in November 2014, officials stated.
In connection with their guilty pleas, each of the defendants admitted that Professional Home Health was operated for the purpose of billing the Medicare program for expensive physical therapy and home health services that were not medically necessary or not provided.
Dennis Hernandez, San Pedro and Alvarez admitted to being managers, supervisors, owners and operators at Professional Home Health.
The trio oversaw the submission of fraudulent claims at Professional Home Health, and falsified patient documentation.
Dennis Hernandez and Alvarez also admitted to similar schemes at additional Miami-area home health agencies.
Additionally, all four defendants admitted to acting as patient recruiters for Professional Home Health.
In this role, they solicited and received kickbacks and bribes from other co-conspirators at Professional Home Health in exchange for recruiting beneficiaries who neither needed, nor, in some cases, received services.
From December 2008 through February 2014, Medicare paid Professional Home Health more than $6.2 million for fraudulent home health claims.
Earlier this year, two other individuals pleaded guilty and were sentenced in connection with the same scheme.
Annarella Garcia, an owner of Professional Home Health, was sentenced to five years and five months in prison.
Annilet Dominguez, an administrator of Professional Home Health, was sentenced to five years and eight months in prison.
Both were also ordered to pay $6.2 million in restitution.
A sentencing hearing for Ernesto Fernandez and Juan Valdes, co-defendants in the case, is scheduled for next week.