Another Miami home healthcare agency owner has pleaded guilty for participating in a Medicare fraud scheme. This scheme resulted in $42 million in false billing against Medicare. Florida has been a hothouse for Medicare and Medicaid fraud, with high dollar schemes thriving in Miami.
Eulises Escalona has pleaded guilty to conspiracy to commit health care fraud. Under his plea agreement, Mr. Escalona will also forfeit to the federal government his two residential properties and the cash proceeds of the fraud.
Mr. Escalona owned Willsand Home Health Inc., which purported to offer Medicare beneficiaries home healthcare and physical therapy services. Mr. Escalona allegedly conspired with patient recruiters in order to bill Medicare for unnecessary home healthcare and physical therapy services. He and his co-conspirators paid bribes and kickbacks to those patient recruiters for referring patients to Willsand Home Health.
Mr. Escalona and his co-conspirators also paid for Plans of Care (POCs), prescriptions, and medical certificates. In exchange for bribes and kickbacks, the recruiters also provided POCs, prescriptions, and certifications for medically unnecessary services. Mr. Escalona and his co-conspirators would also pay bribes and kickbacks to physicians directly for providing POCs, prescriptions, and medical certificates.
With these items, Mr. Escalona and his co-conspirators knowingly violated federal criminal laws by filing false claims against the Medicare program. Mr. Escalona’s home healthcare agency would falsify patient files to provide fraudulent support for services that were medically unnecessary and/or not actually provided to the patients. Over roughly a four year period, Mr. Escalona and his co-conspirators billed Medicare for about $42 million in false claims. Medicare in turn paid about $27 million on those claims, according to the Justice Department.
As has become evident in media reports, healthcare fraud has become a serious burden on public funds. Federal authorities often rely on whistleblowers with information about such fraud. Because of the importance of whistleblowers’ participation, the False Claims Act’s qui tam provision allows whistleblowers to file suit on behalf of the government and share in any recovery.
Waters & Kraus is a national firm with highly skilled lawyers practicing qui tam litigation in four offices, including Dallas, Los Angeles, San Francisco, and Baltimore. Our attorneys have decades of experience successfully representing whistleblowers in a variety of fraud cases. Contact us or call our attorneys at 800.226.9880 to learn more about our practice and how we can assist.