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Health News Florida

Medicare Sting Nabs 50 Floridians

HHS Secretary Kathleen Sebelius and Attorney General Eric Holder oversee the Medicare Fraud Strike Force
HHS Secretary Kathleen Sebelius and Attorney General Eric Holder oversee the Medicare Fraud Strike Force

Fifty-seven people in Tampa and Miami were arrested Tuesday in a nationwide crackdown on Medicare fraud.

HHS Secretary Kathleen Sebelius and Attorney General Eric Holder oversee the Medicare Fraud Strike Force
Credit HHS.gov
HHS Secretary Kathleen Sebelius and Attorney General Eric Holder oversee the Medicare Fraud Strike Force

The U.S. Department of Health and Human Services (HHS) announced that the Medicare Fraud Strike Force made 90 arrests that included 27 doctors and other health care professionals. The schemes involved about $260 million in false billings, the agency said in a news release.

Agents from the FBI, HHS, and other law enforcement agencies helped in the stings in Miami, Tampa, Houston, Los Angeles, Detroit, and Brooklyn, N.Y. Charges allege that defendants in some cases billed the government for medical treatments that were unnecessary, and never conducted on a patient.

Unlike previous busts, this latest sting focused more on those who recruited patients in exchange for bribes. Some of the health care providers charged were accused of taking cash kickbacks in exchange for providing patient information, the HHS said in a statement.

Miami, notorious for its history of Medicare fraud, was the site of 50 new arrests. There, the false billings totaled $65.5 million for home health care, mental health services and pharmacy fraud, authorities said. One laundering scheme, with just two defendants, involved $23 million in pharmacy kickbacks, the HHS said.

The Tampa arrests included seven individuals, some of whom allegedly billed for fraudulent physical therapy treatments, doctor’s visits and tests that never took place. One of the Tampa cases involved billings that used names of patients who lived across the state in Miami-Dade County, officials said.

The South Florida arrests, according to the Miami Herald, included Aventura psychiatrist Barry Kaplowitz, one of four people arrested for work at the Hollywood Pavillion. Kaplowitz is charged with generating $7.5 million in false Medicare claims for his outpatient mental health center in Hollywood, the Herald reports. He is being held without bond.

His attorney says he was only paid $1,250 a month for services at that center, where he worked part-time over a four-year period, the Herald reports. Last year, the Hollywood Pavilion CEO was convicted of Medicare fraud, according to the Herald.

Two Miami brothers, Guillermo Delgado, 42, and Gabriel Delgado, 41, both of Miami, allegedly received kickbacks connected to former pharmacy owner Jose Morales. Morales pleaded guilty to money laundering in 2012, the Herald reports.

Also arrested were four employees of Hialeah’s MCDS Home Health Group: Yulianela Martinez, 32, Luisa Cladera, 53, Leyma Sosa, 39, and Miguel Delgado, 41, according to the Herald.

The five people charged in Tampa are affiliated with several different companies, according to the Tampa Bay Business Journal. David Lovelace, a manager at Tampa’s Summit Health, Lakeland audiologist Terri Schneider and independent Tampa business owner Illya Jackson face a variety of charges, as do Gregory Sylvestri and Leonard Austin, manager of Lake Worth-based BioScan, the Business Journalreports.

The Tampa indictments also charged rehabilitation company presidents Laura Leyva of Kissimmee and Jesus Rabeiro Souto of Miami, in separate conspiracy and money laundering schemes, according to the Business Journal.

This is the seventh national Medicare Fraud takedown by the strike force, a collaborative effort between the HHS and the U.S. Department of Justice. Since 2007, about 1,900 defendants have been charged for fraud totaling nearly $6 billion.

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