Corporate Compliance

Two plead guilty to $25 million healthcare fraud scheme

Compliance Monitor, July 20, 2011

Lisandra Alonso, 33, and Luisa Morciego, 39, each pleaded guilty to one count of conspiracy to commit healthcare fraud for their participation in a $25 million home health Medicare fraud scheme, according to a Department of Justice (DOJ) press release.

According to the DOJ, Alonso was a manager and patient recruiter for the Miami-based ABC Home Health Care, and Morciego, a registered nurse, worked for ABC and Florida Home Health Care Providers Inc.  The two home health care agencies billed Medicare  for expensive physical therapy and home health care services that were medically unnecessary or never provided. The DOJ alleges that the medically unnecessary services were prescribed by doctors, including Jose Nunez, MD, and Francisco Gonzalez, MD. Nunez and Gonzalez were also charged in the February 2011 indictment along with Alonso, Morciego, and 17 other co-conspirators.  

According to the DOJ, Alonso taught the owners and staff of ABC how to operate a fraudulent home health agency. Alonso explained the importance of recruiters, kickbacks, physicians, beneficiaries, and Medicare billing. Alonso negotiated kickback payment rates between patient recruiters and the ABC owners and operators, and distributed the kickback payments to patient recruiters.

Alonso also taught nurses at ABC how to falsify patient files so that patients would qualify for home health services. Moriego falsified records for ABC.

Both Alonso and Morciego face a maximum prison sentence of 10 years, fines, terms of supervised release, and forfeiture of any property or proceeds derived from their criminal activities.

Most Popular