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Four sentenced in Miami Medicare fraud scheme

Compliance Monitor, September 29, 2010

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U.S. District Court Judge Alan S. Gold sentenced three Miami-area residents to prison for their roles in a $22 million Medicare fraud scheme, according to a Department of Justice (DOJ) press release. A fourth individual was sentenced to home detention and supervised release for his participation in the scheme.

According to court documents, Alejandro Hernandez Quiros, 33, a part owner of ABC Home Health Care Inc., admitted that he paid kickbacks to Medicare beneficiaries for the purpose of billing the Medicare program for physical therapy and home health care services that were not medically necessary and/or not provided.

Vicenta Tellechea, 64, a part owner of Florida Home Health Care Provider Inc., admitted that from October 2007 through March 2009 she engaged in a conspiracy to defraud Medicare that involved billing the Medicare program for home health and therapy services that were medically unnecessary and oftentimes not provided.

Carlos Castaneda, 44, recruited Medicare beneficiaries for ABC and Florida Home Health by offering kickbacks and bribes in return for the beneficiaries’ information, which was used to fraudulently bill the Medicare program.

Javier Zambrana was the nominee owner of ABC from approximately January 2006 through August 2007. Zambrana admitted that he signed documents and Medicare provider applications for ABC, purporting to be the true owner of the agency, when the true owners were in fact his parents, Gladys Zambrana and Enrique Perez.

The defendants received the following sentences:

• Quiros - 78 months in prison and three years of supervised release
• Tellechea - 69 months in prison and three years of supervised release
• Castaneda - 40 months in prison and three years of supervised release
• Zambrana - three years of probation, including 12 months of home detention

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