January 27, 2014 —The U.S. Justice Department (“DOJ”) depends on whistleblowers to recover millions of dollars every year that would otherwise be lost to health care fraud. The qui tam provisions in the federal False Claims Act give health care insiders a way to file a lawsuit for the government’s benefit. In return for stepping forward, informants receive a sizeable portion of the government’s eventual proceeds from the claim.
Miami Patient Recruiters Paid Kickbacks for Finding Medicare Beneficiaries to Receive Phony Home Health Care Services
Three patient recruiters who worked for a Florida purported health care provider have pleaded guilty for their roles in a $48 million home health care fraud scheme against Medicare, announced the DOJ.
Between January 2006 and June 2011, Miami residents Omar Hernandez, Marianela Martinez and Celia Santovenia recruited Medicare beneficiaries to become patients for Caring Nurse Home Health Care Corp. Caring Nurse would then bill Medicare for home health care services to the recruited patients, even though the services were not medically necessary or even provided. The trio of medical recruiters received kickbacks from Caring Nurse in exchange for finding the Medicare beneficiaries necessary for the fraudulent billing scam.
In a related case, Caring Nurse’s owners and operators have already been sentenced for their part in the scam.
Health Care Insiders: First Line of Defense Against Fraud
Tipsters willing to collaborate with the DOJ to fight health care fraud should learn about their own rights before moving forward. The Medicare fraud lawyers with Waters & Kraus provide whistleblowers with the legal counsel they deserve. Contact us or phone our False Claims Act attorneys at 855.784.0268 to learn how to file a qui tam lawsuit and how we can help you.