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Miami Man Pleads Guilty to $7.9M Medicare Fraud

This month, one of the many health care fraud cases that made headlines was that of Orelvis Olivera, who entered a guilty plea to a $7.9 million Medicare fraud scheme. He will receive his sentence from a federal judge in late April.

Olivera was the president, owner and operator of Acclaim Home Healthcare, an enterprise that specialized in providing home health care and physical therapy services to Medicare beneficiaries. Until last summer, when he came under scrutiny, Olivera bribed and provided kickbacks to his partners in crime, who referred patients to him so he could bill Medicare for unnecessary services. Over several years, Acclaim Home Healthcare submitted $7.9 million in fraudulent Medicare claims and was reimbursed $7.3 million by Medicare. Olivera has agreed to pay over $5.7 million in restitution.

Federal Prosecution of Health Care Fraud

The FBI is the primary agency involved in investigating and eradicating both federal and private health care fraud. Health care fraud investigations are considered a high priority for the FBI, under its Complex Financial Crime Program. Every FBI field office has investigators who are specially trained and assigned to focus on health care fraud matters. Medicare fraud, which involves collecting payments from Medicare on the basis of false billing or related schemes, is heavily prioritized because it is perceived as impacting some of the most vulnerable health care recipients: the elderly and disabled.

Common Fraudulent Schemes that Attract FBI Attention

Some common activities that can often lead to reports of health care fraud to the FBI, and in turn, a federal investigation, include: providing gifts to Medicare beneficiaries to visit a medical clinics where identifying information is stolen; obtaining patient information by offering “free screenings”; bribing or otherwise inducing medical personnel with access to provide patient insurance information to those involved in fraud; and purchasing identifying information from owners of fraudulent companies or other entities that steal patient and physician billing information.

Potential Punishment for Medicare Fraud

If you have collected funds from Medicare illegitimately, you could be subject to harsh penalties. Medicare fraud is punished more seriously after the passage of the Affordable Care Act. Punishments follow the federals sentencing guidelines, and depending on the severity of the offense can include maximum sentences from 6 months to decades in prison, along with huge fines. In addition, restitution payments for wrongfully obtained funds are almost always ordered by a judge, in order to reimburse the federal government.

Seek Guidance from an Experienced Health Care Fraud Defense Attorney

If you have been charged with health care fraud, or if you believe you are being investigated by the FBI, you should speak to an experienced criminal defense attorney immediately before responding to any investigative inquiries. Like other white collar crimes, health care fraud can be punished with exorbitant fines and lengthy prison sentences. Jeffrey S. Weiner, P.A., a south Florida defense attorney with decades of experience, can offer guidance on how to protect yourself and your reputation from allegations of health care fraud.

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