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RISK MANAGEMENT

Miami medical office manager convicted of Medicare fraud

A former office manager of a Miami-based physical and occupational therapy clinic was convicted, following a four-day trial, for her participation in a scheme that involved the fraudulent submission of more than $3.3 million in false billing to Medicare.

Wifredo A. Ferrer, United States Attorney for the Southern District of Florida, and Shimon Richmond, Special Agent in Charge, U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), made the announcement.

The defendant, 41, of Miami Lakes, was convicted of conspiracy to commit health-care fraud and six substantive counts of health-care fraud.

Evidence presented at trial showed that she had managed and operated Flagler Rehabilitation Center, Inc., a Miami-based physical and occupational therapy clinic, for five years. The defendant was responsible for patient appointments, Medicare billing, the scheduling of therapy sessions, and was the point of contact for co-conspirator therapists who worked at the facility. 

The office manager facilitated the fraudulent conduct at Flagler Rehabilitation Center, Inc. by directing the co-conspirator therapists to write fraudulent evaluations and other falsified documents for patients that were not actually treated at the clinic. The falsified physical and occupational therapy evaluations were prepared in an effort to conceal the Medicare fraud.

The defendant faces a maximum possible sentence of 10 years in prison for each count of conviction.

Mr. Ferrer commended the investigative efforts of HHS-OIG. The case was prosecuted by Assistant U.S. Attorneys James V. Hayes and Amanda Perwin of the U.S. Attorney’s Office for the Southern District of Florida, in coordination with the Fraud Section of the Justice Department’s Criminal Division and the Medicare Strike Force.


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