The owner and operator of a medical clinic in Miami has been sentenced to five years in prison for a wide-ranging Medicare fraud scheme, involving Miami-area home health agencies. Four Miami-area nurses implicated in the Medicare fraud scheme, have also been sentenced.
Yudel Cayro, owner of Courtesy Medical Group, Inc. in Miami, has been ordered to serve two years of supervised released following his 5 year prison term and to pay $9.8 million in restitution.
Cayro admitted that Courtesy operated in part to provide unnecessary prescriptions, plans of care and medical certifications, among other things, to Miami-area home health agencies in return for kickbacks and bribes. Courtesy provided the fraudulent medical documents so that the home health agencies could bill the Medicare program for expensive home health services and therapy purportedly for insulin dependant diabetic Medicare beneficiaries. In fact, the beneficiaries did not need and in some cases did not receive the services.
Aproximately 344 prescriptions for these unnecessary services were issued through Courtesy and signed by Cayro’s co-defendant, Dr. Fred Dweck. As a result, Medicare was fraudulently billed approximately $16.6 million for home health services. Medicare paid almost $10 million of the fraudulent claims. Another owner and operator of Courtesy, co-defendant Arturo Fonseca, was sentenced in November 2010, by Judge Jordan to 60 months in prison and two years of supervised release.
Three of Cayro’s co-defendants, Miami-area nurses Armando Sanchez, Marlenys Fernandez and Silvio Ruiz were sentenced last week to prison for their roles in the scheme. Sanchez and Fernandez were each sentenced to 30 months in prison. Ruiz was sentenced to four months in prison. Judge Jordan also ordered Fernandez to pay $331,622, Sanchez to pay $602,585, and Ruiz to pay $79,230 in restitution.
On Dec. 7, 2010, another co-defendant, registered nurse Sheillah Rotta, was sentenced by Judge Jordan to two months in prison, followed by two years of supervised release, for her participation in the scheme. Rotta was also ordered to pay $74,164 in restitution.
Sanchez admitted that as a result of his actions, more than $900,000 was falsely billed to the Medicare program; Fernandez admitted to causing approximately $500,000 in fraudulent billings to Medicare; Rotta admitted to causing more than $100,000 in fraudulent billing; and Ruiz admitted to causing approximately $115,000 in fraudulent billing.
Additional co-defendants await sentencing in January 2011, including Dr. Fred Dweck, whose sentencing was continued to Jan. 28, 2011.
