The owner of a Michigan home health agency was sentenced to
84 months in prison today for her role in a scheme involving approximately $1.6
million in fraudulent Medicare claims for home health services that were
procured through the payment of kickbacks, and that were medically unnecessary
and not provided.
Assistant Attorney General Brian A. Benczowski of the
Justice Department’s Criminal Division, U.S. Attorney Matthew J. Schneider of
the Eastern District of Michigan, Special Agent in Charge Timothy R. Slater of
the FBI’s Detroit Field Office and Special Agent in Charge Lamont Pugh III of
the U.S. Department of Health and Human Services Office of Inspector General’s
(HHS-OIG) Chicago Regional Office made the announcement.
Editha Manzano, 70, of Troy, Michigan, was sentenced by U.S.
District Judge Gershwin A. Drain of the Eastern District of Michigan. Judge Drain also ordered Manzano to pay
$1,593,804.35 in restitution, jointly and severally with her co-conspirators,
and to forfeit $758,407.07. On Dec. 4,
2017, Manzano was convicted after a two-week trial on all counts that were
charged in the indictment -- one count of conspiracy to commit health care and
wire fraud, one count of conspiracy to pay and receive kickbacks in connection
with Medicare beneficiaries, and one count of health care fraud.
According to evidence presented at trial, from 2013 to 2016,
Manzano masterminded a scheme to defraud Medicare of approximately $1.6 million
by submitting false and fraudulent claims for home health care services in
connection with Anointed Care Services (Anointed), a Detroit-area home health
care agency. Medicare requires that
physical therapy and skilled nursing services in the home be provided only to
Medicare beneficiaries who are homebound and need the services. The evidence showed that Manzano paid illegal
kickbacks in exchange for recruited beneficiaries’ signatures on blank home
health documents. The evidence further
showed that Manzano conspired with physicians to admit beneficiaries for home
health care with Anointed when they did not qualify for such services. Manzano and her co-conspirators then billed
Medicare for home health services that were never provided, the evidence
showed. To make it appear that the
services were medically necessary and actually provided, Manzano and her
co-conspirators fabricated and falsified medical records, the evidence showed.
The evidence further showed that Manzano conspired with
physicians to provide medically unnecessary opioids to beneficiaries who signed
up for home health care with Anointed.
Some of these beneficiaries sold the opioids to drug dealers to be resold
on the street; others traded the opioids to drug dealers in exchange for crack
cocaine.
Manzano was charged along with Liberty Jaramillo, 68, also
of Troy; Roberto Quizon, M.D., 72, of Bloomfield Hills, Michigan; Juan Yrorita,
R.N., 64, of Sterling Heights, Michigan, and Victoria Gallardo-Navarra, M.D.,
75, also of Bloomfield Hills, in an indictment returned on Sept. 1, 2016. Jaramillo and Quizon pleaded guilty prior to
trial and were sentenced to serve 36 months and 18 months in prison,
respectively. Gallardo-Navarra was
acquitted, and Yrorita pleaded guilty on the fifth day of trial and was
sentenced to serve 36 months in prison.
The FBI and HHS-OIG investigated the case, which was brought
as part of the Medicare Fraud Strike Force under the supervision of the
Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the
Eastern District of Michigan. Trial
Attorneys Jacob Foster and Rebecca Yuan of the Fraud Section prosecuted the
case.
The Criminal Division’s Fraud Section leads the Medicare
Fraud Strike Force. Since its inception in March 2007, the Medicare Fraud
Strike Force, which maintains 14 strike forces operating in 23 districts, has
charged nearly 4,000 defendants who have collectively billed the Medicare
program for more than $14 billion.
Posts
No comments:
Post a Comment