OWNER OF DURABLE MEDICAL EQUIPMENT COMPANIES SENTENCED TO 41 MONTHS IN PRISON

FROM: U.S. DEPARTMENT OF JUSTICE
Thursday, April 18, 2013
Owner of Texas Durable Medical Equipment Companies Sentenced to 41 Months

Hugh Marion Willett, the owner of two Texas-based durable medical equipment companies, was sentenced today to 41 months in prison, followed by three years of supervised release, and ordered to pay $182,450 in restitution, announced Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division.

Willett, 69, of Fort Worth, Texas, was found guilty in January by U.S. District Judge Jane J. Boyle in the Northern District of Texas on all seven counts of a June 2012 second superseding indictment: one count of conspiracy to commit health care fraud and six counts of health care fraud stemming from a durable medical equipment (DME) fraud scheme. His wife, Jean Willett, previously pleaded guilty to the same charges and was sentenced in September 2012 to 50 months in prison.

The evidence at trial showed that between 2006 and 2010, the Willets co-owned and operated JS&H Orthopedic Supply LLC and Texas Orthotic and Prosthetic Systems Inc., which claimed to provide orthotics and other DME to beneficiaries of Medicare and private insurance benefit programs including Aetna, Blue Cross Blue Shield and CIGNA.

Evidence presented in court proved that both of these companies intentionally submitted claims to Medicare and other insurers for products that were materially different from and more expensive than what was actually provided, and that Hugh Marion Willett was a knowing and willful participant in the fraud.

The case was investigated by the FBI and the Department of Homeland Security’s Office of Inspector General and brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section. The case was prosecuted by Fraud Section Trial Attorney Ben O’Neil.

Since their inception in March 2007, strike force operations in nine locations have charged more than 1,480 defendants who collectively have falsely billed the Medicare program for more than $4.8 billion. In addition, the Centers for Medicare and Medicaid Services, working in conjunction with the Office of Inspector General for the U.S. Department of Health and Human Services, are taking steps to increase accountability and decrease the presence of fraudulent providers.

OWNERS/EMPLOYEES PLEAD GUILTY TO HOME HEALTH CARE FRAUD

FROM THE DEPARTMENT OF JUSTICE
 Monday, April 2, 2012
Two Owners and Two Employees of Miami Home Health Company Plead Guilty in $20 Million Health Care Fraud Scheme

WASHINGTON – Two owners and two employees of a Miami home health care agency pleaded guilty for their participation in a $20 million Medicare fraud scheme involving false billings for home health care services, announced the Department of Justice, the FBI and the Department of Health and Human Services (HHS).

Ariel Rodriguez, 41, Reynaldo Navarro, 37, and Ysel Salado, 26, each pleaded guilty today before U.S. District Judge Marcia G. Cooke to one count of conspiracy to commit health care fraud, and Melissa Rodriguez, 24, pleaded guilty on March 28, 2012, before Judge Cooke to the same charge.
           
According to court documents, Ariel Rodriguez and Reynaldo Navarro were the owners of Serendipity Home Health Inc., a Florida home health agency that purported to provide home health care and physical therapy services to eligible Medicare beneficiaries.  Melissa Rodriguez and Ysel Salado were employees at Serendipity Home Health.

According to plea documents, Ariel Rodriguez, Navarro and their co-conspirators paid kickbacks and bribes to patient recruiters.  In return, the recruiters provided patients to Serendipity, as well as prescriptions, plans of care (POCs) and certifications for medically unnecessary therapy and home health services.  Ariel Rodriguez and Navarro used the prescriptions, POCs and medical certifications to fraudulently bill the Medicare program, which Ariel Rodriguez and Navarro knew was in violation of federal criminal laws.
Melissa Rodriguez and Salado admitted that they cashed checks from Serendipity and provided the cash to Ariel Rodriguez and Navarro to use for the kickback payments.
According to plea documents, Serendipity nurses and office staff falsified patient files for Medicare beneficiaries to make it appear that the beneficiaries qualified for home health care and therapy services.  In fact, the beneficiaries did not actually qualify for and did not receive such services.  Ariel Rodriguez and Navarro admitted that they knew files were falsified so that Medicare could be billed for medically unnecessary services.

From approximately April 2007 through March 2009, Ariel Rodriguez, Navarro and their co-conspirators submitted approximately $20 million in false and fraudulent claims to Medicare.  Medicare paid approximately $14 million on those claims.
The pleas were announced today by Assistant Attorney General Lanny A. Breuer of the Justice Department’s Criminal Division; U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida; John V. Gillies, Special Agent-in-Charge of the FBI’s Miami Field Office; and Special Agent-in-Charge Christopher Dennis of the HHS Office of Inspector General (HHS-OIG), Office of Investigations Miami Office.

This case is being prosecuted by Trial Attorney Joseph S. Beemsterboer of the Criminal Division’s Fraud Section.  The case was investigated by the FBI and HHS-OIG, and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida.

Since their inception in March 2007, Medicare Fraud Strike Force operations in nine locations have charged more than 1,190 defendants who collectively have falsely billed the Medicare program for more than $3.6 billion.  In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.