A therapy staffing company owner was sentenced to 46 months in prison and ordered to pay $1.9 million in restitution for his participation in a $7 million healthcare fraud scheme, the U.S. Attorney’s Office reported. In addition, a patient recruiter for a nursing home was sentenced to 50 months in prison and $6.9 million in restitution in the same case.
Hugo Morales, 37, owned Professionals Therapy Staffing Services Inc., which provided therapists to Anna Nursing, a Miami home healthcare agency, according to the U.S. Attorney’s Office. Ivan Alejo, 48, was a patient recruiter at Anna Nursing.
Anna Nursing was paid approximately $7 million between October 2010 and April 2013 for fraudulent claims for home healthcare services that were not medically necessary and/or not provided, according to the U.S. Attorney’s Office.
Morales’ primary role in the scheme included creating 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, according to the U.S. Attorney’s Office. Morales knew the documents he and others from Professionals Therapy falsified were used to support false claims for home healthcare services billed to Medicare by his co-conspirators at Anna Nursing, which Morales knew was in violation of federal criminal laws, according to the U.S. Attorney’s Office.
Alejo’s primary role in the scheme at Anna Nursing involved negotiating and paying kickbacks and bribes, interacting with patient recruiters and assisting in the submission of fraudulent claims to the Medicare program, according to the U.S. Attorney’s Office.
Morale and Alejo had pleaded guilty in August 2013.