Three Individuals Convicted in $93M Home Health Fraud Scheme

MIAMI—A federal jury in Miami convicted a Florida man and woman for their roles in a conspiracy to defraud Medicare by billing more than $93 million for home health therapy services that were never rendered.

According to court documents and evidence presented at trial, Karel Felipe, 42, of Miami Shores, and Tamara Quicutis, 54, of Hialeah, conspired with others to submit false bills to Medicare for three home health companies located in Michigan. Their co-conspirators recruited individuals from Cuba to sign Medicare enrollment documents and appear as the owners of the home health agencies to conceal the identities of Felipe, Quicutis and others involved in the scheme. Felipe, Quicutis and their co-conspirators used these home health companies to submit claims for services that were not rendered using lists of stolen patient identities. Felipe, Quicutis and their co-conspirators used hundreds of shell companies and bank accounts to launder the Medicare fraud proceeds and convert the proceeds into cash at Miami-area ATMs and check cashing stores.  

After the trial commenced, a third defendant, Jesus Trujillo, 52, of Miami, pleaded guilty to one count of conspiring to commit health care fraud and wire fraud and one count of conspiring to commit money laundering. Trujillo oversaw a group of people that recruited nominee owners for home health agencies and shell companies and converted Medicare fraud proceeds into cash.

The jury convicted Felipe and Quicutis of conspiracy to commit health care fraud and wire fraud, and conspiracy to commit money laundering. They are scheduled to be sentenced on Jan. 4, 2024, and they face a maximum penalty of 20 years in prison on each conspiracy charge. Trujillo is scheduled to be sentenced on Dec. 21 and faces a maximum penalty of 20 years in prison on each count. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.

Acting Assistant Attorney General Nicole M. Argentieri of the Justice Department’s Criminal Division, U.S. Attorney Markenzy Lapointe for the Southern District of Florida, Special Agent in Charge Jeffrey B. Veltri of the FBI Miami Field Office, and Special Agent in Charge Omar Pérez Aybar of the Department of Health and Human Services Office of the Inspector General (HHS-OIG) Miami Regional Office made the announcement.

The FBI and HHS-OIG investigated the case.

Trial Attorneys Jamie de Boer, D. Keith Clouser, and Emily Gurskis of the Criminal Division’s Fraud Section are prosecuting the case. Assistant U.S. Attorney Gabrielle Charest-Turken for the Southern District of Florida is handling asset forfeiture.

The Fraud Section leads the Criminal Division’s efforts to combat health care fraud through the Health Care Fraud Strike Force Program. Since March 2007, this program, comprised of 15 strike forces operating in 25 federal districts, has charged more than 5,000 defendants who collectively have billed federal health care programs and private insurers more than $24 billion. In addition, the Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, are taking steps to hold providers accountable for their involvement in health care fraud schemes. More information can be found at www.justice.gov/criminal-fraud/health-care-fraud-unit.