The Miami-based owner and administrator of two home health care companies was sentenced to 80 months in prison today and will pay $45 million in restitution after pleading guilty to one count of conspiracy to commit health care fraud. Elsa Ruiz, the 45-year-old owner of Professional Home Health Care Solutions Inc. and administrator of LTC Professional Consultants Inc., pleaded guilty in July for her role in a Medicare fraud scheme worth $74 million.
Both of Ruiz’s companies purported to provide home health care and therapy services to Medicare beneficiaries. According to the Justice Department, Ruiz and others involved in the scheme fraudulently billed Medicare between 2006 and 2012 for expensive physical therapy and home care services that were not medically necessary or never provided. According to her own testimony, Ruiz negotiated and paid out kickbacks to patient recruiters in exchange for patient referrals, prescriptions, plans of care and certifications for physical therapy and home care services that were not medically necessary. During the time when both companies were fraudulently billing Medicare, the government paid out approximately $45 million.
Individuals who file a False Claims complaint and report fraud schemes like this to the United States may be entitled to a reward of up to 25% of any money that the government recovers. It’s an opportunity to be rewarded for doing what’s right. Anyone thinking about reporting fraud to the government should consult with an attorney experienced in this area of law.