by | last updated on January 10, 2016

MIAMI (June 21) – Two Miami home health care agency owners of a were sentenced to 73 and 74 months in prison for their participation in a $20 million home health Medicare fraud scheme.
Ariel Rodriguez was to 73 months in prison and three years of supervised release and Reynaldo Navarro was sentenced to 74 months in prison followed by three years of supervised release and were ordered to pay $14 million in restitution. Rodriguez, 41, Navarro, 37, were the owners of Serendipity Home Health Inc., a Miami home health agency that was supposed to provide home health care and physical therapy services to qualifying Medicare beneficiaries.
According to court records, Rodriguez and Navarro paid kickbacks and bribes to patient recruiters in exchange for the recruiters providing patients to their home health care agency, as well as prescriptions, plans of care and certifications for medically unnecessary therapy and home health services for Medicare beneficiaries. The prescriptions, POCs and medical certifications were then submitted to Medicare for reimbursement.
Court documents claimed nurses and office staff falsified patient files for Medicare beneficiaries to make it look as if the beneficiaries qualified for home health care and therapy services. Rodriguez and Navarro knew that the beneficiaries did not qualify for and did not receive such services, but these files were falsified nevertheless so that Medicare could be billed.
Rodriguez, Navarro and their co-conspirators submitted almost $20 million in false and fraudulent claims to Medicare, of which Medicare paid approximately $14 million.