Miami-Area Nurse Pleads Guilty in $25 Million Health Care Fraud Scheme

WASHINGTON—Miami-area resident Farah Maria Perez, a registered nurse, pleaded guilty today for her participation in a $25 million Medicare fraud scheme involving false billings for home health services, announced the Department of Justice, the FBI and the Department of Health and Human Services (HHS).

Perez, 40, pleaded guilty before U.S. District Judge Joan A. Lenard in Miami to one count of conspiracy to commit health care fraud. She was originally charged in a February 2011 indictment.

According to plea documents, Perez worked for Florida Home Health Care Providers Inc., a Miami home health care agency that purported to provide home health and therapy services to Medicare beneficiaries. Perez and her co-conspirators operated Florida Home Health for the purpose of billing the Medicare program for expensive physical therapy and home health care services that were medically unnecessary and/or never provided. The medically unnecessary services were prescribed by doctors.

According to court documents, beginning in approximately January 2006 and continuing until approximately March 2009, Perez and her co-defendant nurses falsified patient files for Medicare beneficiaries to make it appear that they qualified for home health care and therapy services from Florida Home Health. Perez admitted that she knew the beneficiaries did not actually qualify for and did not receive the services. Perez and her co-defendant nurses described in nursing notes and patient files symptoms such as tremors, impaired vision, weak grip, and inability to walk without assistance. Although the patients did not actually exhibit these symptoms, the symptoms were nevertheless included in patient files to make it appear that the patients were unable to self-inject insulin and were homebound, thus appearing to qualify for home health care benefits under Medicare. Perez admitted that she knew the files were falsified so that the Medicare program could be billed for medically unnecessary therapy and home health related services. As a result of Perez’s participation in the illegal scheme, the Medicare program was billed approximately $118,000 for purported home health care services that were medically unnecessary and/or never provided.

Perez also admitted that she recruited Medicare beneficiaries who would allow Florida Home Health to bill the Medicare program for home health care and therapy services that were unnecessary or never provided. Perez solicited and received kickbacks and bribes from the owners and operators of Florida Home Health in return for allowing Florida Home Health to bill Medicare on behalf of the patients she recruited. Perez knew that the patients did not qualify for the services that were billed to Medicare.

Four other co-conspirators who were charged in the February 2011 indictment for their roles in the Florida Home Health fraud scheme have pleaded guilty: Jose Nunez, M.D.; Lisandra Alonso; Luisa Morciego; and Vicente Guerra.

Sentencing for Perez is scheduled for Nov. 14, 2011.

The charge of conspiracy to commit health care fraud carries a maximum prison sentence of 10 years. The defendant also face fines and terms of supervised release, as well as forfeiture of any property or proceeds derived from her criminal activities.

Today’s charges were announced by Assistant Attorney General Lanny A. Breuer of the Criminal Division; U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida; John V. Gillies, Special Agent in Charge of the FBI’s Miami Field Office; and Special Agent in Charge Christopher Dennis of the HHS Office of Inspector General (HHS-OIG), Office of Investigations Miami office.

This case is being prosecuted by Trial Attorney Joseph S. Beemsterboer of the Criminal Division’s Fraud Section. The case was investigated by the FBI and HHS-OIG, and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Miami.

Since their inception in March 2007, Strike Force operations in nine locations have obtained indictments of more than 1,000 defendants who collectively have falsely billed the Medicare program for more than $2.3 billion. In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.