What is Medicare Fraud?

Medicare fraud occurs when a hospital, nursing home, doctor's office, hospice care facility, ambulance service, pharmacy, rehabilitation center, or any other type of healthcare provider overbills Medicare.


Who can report Medicare fraud?

Medicare fraud whistleblowers are almost always healthcare professionals. They are commonly employed as hospital administrators, nurses, hospice or nursing home workers, ambulance drivers, pharmacists, or as any other type of healthcare professionals.

Receive a financial reward for your information.

Healthcare professionals may be entitled to a significant financial reward for becoming Medicare whistleblowers. Learn about receiving a financial reward for your information here.


Home Health Agency Owner Pleads Guilty to Medicare Fraud
Print E-mail

On January 24, 2012, the Department of Health and Human Services issued a statement claiming that Marietha Morales, the owner of Prime Home Health, and Eduardo Saborit Dominguez, an employee the agency, plead guilty to their involvement in a 22 million home health care fraud scheme before U.S. District Judge Seitz. Morales confirmed that she was guilty of one count of conspiracy to commit healthcare fraud and her employee Saborit Dominguez pleaded guilty to his involvement of violating the anti-kickback statue.

Prime Home Health Services Inc., was a Florida home healthcare center, which included physical therapy services, to those individuals who were eligible for Medicare benefits. The employees at the agency produced patient files to make it look like patients were qualified for more benefits than needed. Beginning in February 2005 to April 2011, the agency collected over $22 million in false claims to Medicare. Medicare reportedly paid about $14 million to those claims. 

During this period, Morales cooperated with patient recruiters for the sole purpose of obtaining Medicare assistance for services, which she claimed her company provided. To accomplish this task, she and her employees paid kickbacks and bribes to recruiters. In return, the recruiters were then excepted to provide patients to Prime Home Health along with prescriptions and other falsified documents that would make Medicare believe her claims. Saborit Dominguez is the only employee who committed most of the distributing of the kickbacks and bribes to recruiters. 

Both parties knew that their actions were in violation of the federal criminal laws but still continued to falsify files and documents. The amount of time each must serve will be decided on May 23, 2012. Usually the charge of falsify healthcare documents holds a maximum sentence of at least 10 years. The charges against the two defendants would have gone unfounded if not for the Medicare Fraud Strike Force. The organization operates in nine locations and has filed charges against more than 1,140 defendants, who have lied on documents. If payments would have been made, it would have led to over 2.9 billion dollars in claims.

Report Medicare fraud here.

Help stop government waste and abuse, and get rewarded for your efforts. Our attorneys have significant experience representing healthcare industry whisteblowers. Complete the secure form on this page or call 1-800-581-1790 for a free no obligation consultation with a lawyer.