South Florida Fraud Cases Just Keep On Coming

MIAMI — The owner of 13 South Florida DME companies and
three clinics pleaded guilty to criminal charges in connection with
a Medicare scheme involving nearly $57 million in false claims,
federal prosecutors announced Nov. 14.

According to a statement from R. Alexander Acosta, U.S. attorney
for the Southern District of Florida, defendant Miguel Almanza and
his co-conspirators concealed their control of the DME companies
and clinics, located in Miami-Dade and Hillsborough counties, by
recruiting “nominee” or “straw owners,” who were typically paid a
percentage of the fraud proceeds to sign the necessary corporate
records and Medicare applications.

“Notably, Almanza often recruited family members or recent
immigrants from his hometown of Moron, Cuba, to serve as the
nominee owners of his DME companies,” the statement said.

The companies submitted $56.7 million in false claims for
medical equipment including nebulizers, oxygen concentrators,
powered air mattresses and wheelchairs.

In the scheme, Almanza purchased the identities of beneficiaries
and used their Medicare numbers to submit the claims. During the
early years of the conspiracy, Almanza and his partners paid
monthly cash kickbacks to these “professional patients” so they
would not report the false claims to Medicare, according to the
statement.

But over time, “the scheme changed because Almanza and his
partners found it cumbersome to pay kickbacks to dozens of
patients. Consequently, Almanza and his partners began to purchase
stolen patient identities from patient recruiters and billing
companies.”

Once Medicare paid the false claims, some proceeds were
laundered by distributing pre-signed corporate checks, often for
amounts just under $10,000, to a network of so-called “check
cashers,” who were paid a typical 10 percent commission to cash the
checks at local banks.

Under a second laundering scheme, nominee owners were recruited
to open various sham corporations, including construction companies
and investment firms. The Medicare proceeds were deposited into
those companies’ bank accounts and then later distributed to
Almanza and his partners, the statement said, adding: “Almanza used
the fraud proceeds to purchase a home, luxury cars and to finance
other lavish personal expenditures. Almanza also used the funds for
gambling at various South Florida casinos, where he often spent
more than $10,000 per night.”

Almanza faces a maximum 10-year prison term for the Medicare
conspiracy, and five years for making false claims upon the United
States.

View a list of the DME companies involved.

The scheme follows another $17 million South Florida fraud case
that kept things all in the family.

According to a statement from Acosta, defendants David Hernandez
and his wife Laura Hernandez of Pembroke Pines, Fla., began
defrauding Medicare as early as 1999 when they opened two DME
companies, Florida DME and On-Time Medical Equipment Rentals, and
used them to submit $5.9 million of false claims. Laura Hernandez
then formed Triple AAA Billing, which processed and submitted the
companies’ electronic claims.

In 2003, David Hernandez expanded the scheme when he opened SOS
DME with co-defendant Magaly Martinez, the receptionist at On-Time
Medical. Later, Hernandez opened additional DME companies with
three of Martinez’ family members, including YYS Medical Supply
with Martinez’ son, defendant Yuniel Echevarria; All County Medical
Equipment with Martinez’ husband, defendant Jose Echevarria; and
Tri-County Medical Supplies with Martinez’ daughter-in-law,
defendant Suyima Torres. These four DMEs submitted another $11.3
million in false Medicare claims that were processed by Laura
Hernandez’ company, Triple AAA Billing.

David Hernandez’ brother, defendant Jose Miguel Hernandez,
helped to promote the scheme and conceal the false claims by
delivering kickbacks “to a vast network of ‘professional patients’
who were paid to sell their Medicare cards,” the statement said.
“When Jose Miguel Hernandez visited each patient’s home, he would
instruct them to sign ‘delivery receipts,’ which created the
appearance that the patients had received durable medical
equipment. In fact, howver, the patients did not receive any
equipment. After the patients signed the necessary forms, Hernandez
would pay them cash, often $200 to $300 per visit.”

David Hernandez, Laura Hernandez, and Jose Miguel Hernandez face
a maximum of 10 years in prison on the Medicare fraud offenses.

In separate cases in July, co-conspirators Magaly Martinez, Jose
Echevarria, Yuniel Echevarria and Suyima Torres pled guilty to
Informations charging them each with one count of conspiracy to
commit health care fraud.