This week, it was announced that the owner and operator of a now defunct Miami, Florida home health agency had been sentenced to prison for conspiracy to defraud the Medicare program. 38-year-old Yunesky Fornaris of Miami was sentenced to 115 months in prison for his involvement in a $15 million conspiracy to defraud Medicare. The defendant has also been ordered to pay $15.1 million in restitution and to forfeit the gross proceeds traced to the offense. Fornaris pleaded guilty to one count of conspiracy to commit wire fraud on October 3.
As part of his guilty plea, the defendant admitted that from April 2010 and July 2016, he owned, controlled and managed Elite Home Care LLC. He and his co-conspirators submitted false and fraudulent home health care claims from Elite to the Medicare program using interstate wire. The defendant also admitted to concealing his true ownership interest in Elite Home Care by not listing his interest on the Medicare enrollment application.
The defendant also enlisted patient recruiters to recruit patients in exchange for illegal bribes and kickbacks. Fornaris admitted he knew that many of his patients were not eligible for home care services, because they were not homebound. Had Medicare known about the bribes and kickbacks, it would not have paid the claims submitted on behalf of those beneficiaries.
Additional details can be found here.