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Two people, including a staffing firm owner, pleaded guilty Wednesday to one count each of conspiracy to commit healthcare fraud in connection with a $7 million health scheme involving a now-defunct home health care agency in Miami Springs, Fla., the Department of Justice reported.
Patient recruiter Ivan Alejo and staffing firm owner Hugo Morales each face a maximum sentence of 10 years.
Alejo worked for Anna Nursing, which purported to provide home health and therapy services to Medicare beneficiaries. From approximately October 2010 through approximately April 2013, Medicare paid Anna Nursing approximately $7 million for fraudulent claims for home health care services that were not medically necessary and/or not provided, according to the Department of Justice. Morales owned Professionals Therapy Staffing Services Inc., which provided therapists to Anna Nursing.
According to the Department of Justice, Morales and others created fictitious progress notes and other patient files indicating that therapists from Professionals Therapy had provided physical or occupational therapy services to particular Medicare beneficiaries, when in many instances those services had not been provided and/or were not medically necessary. Morales knew the falsified documents were used to support false claims for home health care services billed to Medicare by his co-conspirators at Anna Nursing.
Morales and Alejo are scheduled to be sentenced on Nov. 5.