Eulises Escalona, owner of the Miami-based Willsand Home Health Inc., will serve 10 years in prison for his part in a Medicare fraud scheme perpetrated between 2006 and 2009. Mr. Escalona and his co-conspirators submitted about $42 million in false claims to Medicare, and the Medicare program paid about $27 million on those fraudulent claims. Mr. Escalona was also ordered to pay $26.5 million in restitution, according to the Justice Department.
Home Health Co. Owner Paid Recruiters and Solicited Prescriptions for Medicare Fraud
Mr. Escalona pleaded guilty in August of this year to conspiracy to commit healthcare fraud. He admitted that he paid and conspired with patient recruiters to identify Medicare beneficiaries, obtain their personal information, and bill Medicare for unnecessary therapy and home health services. Mr. Escalona conspired to bribe and pay kickbacks to physicians to prescribe home health and therapy services for these patients.
Ms. Escalona used the prescriptions and other documents obtained from the physicians to fraudulently bill Medicare for home health and therapy services although Mr. Escalona knew these false claims violated federal criminal laws. To support these fraudulent claims, patient files were falsified to give the appearance that the Medicare beneficiaries qualified for those services even though many were ineligible for them.
Whistleblowers Have the Evidence Authorities Need to Fight Medicare Fraud
Authorities battling Medicare fraud rely on information provided by whistleblowers. In recognition of their important role, the qui tam provisions of the False Claims Act permit whistleblowers to file suit on behalf of the government and share in any funds recovered.
The attorneys at Waters & Kraus have extensive experience representing whistleblowers. Contact us or call our whistleblower attorneys at 800.226.9880 to learn more about our practice and how we can assist.
