A home health services company owner and a co-conspirator, both Miami, Florida residents, were sentenced to prison today for their roles in a $8.6 million health care fraud scheme.
Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Ariana Fajardo Orshan of the Southern District of Florida, Special Agent in Charge George L. Piro of the FBI’s Miami Field Office, Special Agent in Charge Shimon R. Richmond of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Miami Regional Office and Miami Air and Marine Branch Director Martin G. Wade of the U.S. Customs and Border Protection (CBP) Air and Marine Operations made the announcement.
Alexander Ros Lazo (Ros Lazo), 54, the owner of T.L.C. Health Services of Miami, was sentenced to serve 87 months in prison. Misleady Ibarra, 46, who performed home health therapy services without a license, was sentenced to serve 24 months in prison. The defendants were sentenced by U.S. Circuit Judge Adalberto Jordan sitting in the Southern District of Florida. Judge Jordan also ordered Ros Lazo to pay $8,603,859 in restitution and to forfeit the same amount, and Ibarra to pay restitution in an amount to be determined. Ibarra and Ros Lazo pleaded guilty in December 2018 to one count of conspiracy to commit health care fraud. Both defendants were charged in an indictment returned on June 21, 2018.
As part of his guilty plea, Ros Lazo admitted that he paid kickbacks and bribes to his co-conspirators in exchange for home health services prescriptions and the referral of Medicare beneficiaries to T.L.C. Health Services. He further admitted that he and Ibarra agreed with their co-conspirators to commit health care fraud by billing Medicare for physical therapy services performed by Ibarra on behalf of licensed therapists despite knowing that she was not licensed to render those services to the Medicare beneficiaries. Ros Lazo admitted that as a result of the fraudulent claims, Medicare paid $8.6 million in benefits that it otherwise would not have.
As part of her guilty plea, Ibarra admitted to conspiring with Ros Lazo to commit health care fraud by rendering home health therapy services to Medicare beneficiaries when Ibarra was not licensed to provide these services.
The case was investigated by the FBI, HHS-OIG and CBP Air and Marine Operations. Trial Attorneys Alexander Kramer and Sara Clingan of the Criminal Division’s Fraud Section and Assistant U.S. Attorney Yisel Valdes of the Southern District of Florida prosecuted the case.
The Fraud Section leads the Medicare Fraud Strike Force, which is part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. Since its inception in March 2007, the Medicare Fraud Strike Force, which maintains 14 strike forces operating in 23 districts, has charged nearly 4,000 defendants who have collectively billed the Medicare program for more than $14 billion.