January 2, 2014 — The U.S. Department of Justice depends on whistleblowers to help the government recoup millions of dollars each year that could be lost to unscrupulous Medicare scams. The qui tam language in the federal False Claims Act gives health care insiders a powerful weapon for tackling fraud in their industry. In return for bringing a claim on the government’s behalf, insiders retain a share of any proceeds recovered from a whistleblower lawsuit. Health care workers are well situated to collaborate with the government about Medicare fraud scams because they are usually the first to see the fraud in practice.
Miami Man Sentenced in $20 Million Medicare Scam Involving Bribes and Kickbacks to Health Care Workers and Patient Recruiters
Roberto Marrero, who owned and ran several Florida health care agencies, has been sentenced to a 120-month prison sentence for his part in a Medicare fraud scheme involving Trust Care Health Services Inc., a home health care company that is now defunct. In September 2013, Marrero pleaded guilty to health care fraud charges related to Trust Care, which purported to provide physical therapy and home health services to Medicare beneficiaries living in Miami. Some of Marrero’s co-conspirators had already been sentenced after pleading guilty for their roles in the Medicare fraud scam: Sandra Fernandez Viera; Patricia Morcate; and Enrique Rodriguez.
According to the U.S. Department of Justice, Marrero and Fernandez Viera were co-owners and operators of the home health care agency. The two ran Trust Care so they could bill Medicare for expensive home health care and physical therapy that were not needed and/or were not provided. The conspirators paid off patient recruiters with bribes and kickbacks in return for the referral of Medicare beneficiaries for whom the conspirators could bill their phony charges. Marrero and his co-conspirators also paid off insiders at local Miami doctors’ offices and clinics who provided Trust Care with fraudulent prescriptions for home health and therapy as well as other documentation used in the Medicare fraud scam. Marrero was fully aware that the entire operation violated federal criminal laws.
Marrero had primary control of the company and oversaw Trust Care’s various Medicare fraud schemes. He negotiated and paid the necessary bribes, interacted with patient recruiters, and directed the submission of false claims to Medicare. Between March 2007 and October 2010, Trust Care filed over $20 million in fraudulent Medicare claims, of which more than $15 million were paid.
This was not the only fraudulent home health care agency run by Marrero and his co-conspirators. The conspirators have also acknowledged their roles in bilking Medicare out of $50 million in connection with false claims filed by several other Florida home health services agencies.
Health Care Insiders Critical to Ending Medicare Fraud
False Claims Act violations involving fraudulent claims to Medicare are uncovered most often by health care employees. Tipsters who are thinking about collaborating with the Justice Department should learn everything they can about the whistleblower process before moving forward. The qui tam lawyers with Waters & Kraus offer brave informants the legal counsel they deserve. Contact us by email or call our False Claims Act attorneys at 855.784.0268 to learn more about our health care fraud practice.