On Friday, April 20, 2018, it was announced that a Miami, Florida man had been sentenced to 97 months in prison for his involvement in an approximately $10 million health care fraud scheme. The scheme involved a now-defunct clinic and two sham physical rehabilitation clinics in Miami. 52-year-old Vladimir Prado Sr. pleaded guilty to a single count of conspiracy to commit health care fraud and wire fraud on February 2, 2018. The defendant admitted that he owned a Miami medical clinic that submitted roughly $5 million in fraudulent claims to Blue Cross Blue Shield.
The claims resulted in the clinic receiving approximately $1.4 million. He also admitted to providing the money to purchase a fraudulent home health agency. From December 2012 through April 2014, the defendant and his co conspirators submitted approximately $2.2 million in claims for reimbursement to the Medicare program. Those claims falsely represented that various home health benefits were medically necessary, prescribed by a doctor and provided to Medicare beneficiaries.
As a result, Medicare made approximately $3.9 million in payments to the home health agency. Again, Vladimir Prado Sr. has been sentenced to 97 months in prison. Additional details can be found here.