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Miami woman sentenced in Medicare fraud

Medicare-fraud

A Miami healthcare professional involved in two local companies was sentenced Wednesday to 60 months in prison for participating in a $74 million home health Medicare fraud scheme. 

Myriam Acevedo, 63, of Miami, was sentenced by U.S. District Judge Marcia G. Cooke in the Southern District of Florida, after pleading guilty in May to a conspiracy to pay health care kickbacks.

Acevedo was an administrator of LTC Professional Consultants Inc. (LTC) and an employee of Professional Home Care Solutions Inc., home health care agencies that purported to provide home health and therapy services to Medicare beneficiaries.  Acevedo and her co-conspirators agreed to and operated LTC and Professional for the purpose of billing the Medicare program for, among other things, expensive physical therapy and home health care services that were not medically necessary and/or were not provided.

Acevedo’s primary role in the scheme was to pay kickbacks and bribes to patient recruiters of LTC and Professional. As part of this role, Acevedo and others would distribute cash to patient recruiters in exchange for providing patients to LTC and Professional, as well as prescriptions, plans of care (POCs) and certifications for medically unnecessary therapy and home health services for Medicare beneficiaries.  Acevedo and her co-conspirators would use these prescriptions, POCs and medical certifications to fraudulently bill the Medicare program for home health care services, which Acevedo knew was in violation of federal criminal laws.

From approximately September 2007 through June 2012, LTC and Professional submitted approximately $41 million in claims for home health services that were not medically necessary and/or not provided.  Medicare actually paid approximately $27 million for these fraudulent claims. The  overall scheme fraudulently billed Medicare more than $74 million.

Since their inception in March 2007, Medicare Fraud Strike Force operations in nine locations have charged more than 1,500 defendants who collectively have falsely billed the Medicare program for more than $5 billion.  

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