An owner of a Florida medical clinic was sentenced to serve 91 months in prison today for her role in a $2.5 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 Special Agent in Charge Brian Swain of the U.S. Secret Service’s (USSS) Miami Field Office made the announcement.
Juliette Anais Tamayo, 54, the owner of Miami-based clinic Sunshine Medical Care Group Inc. (Sunshine), was sentenced by U.S. District Judge Cecilia Altonaga of the Southern District of Florida. Judge Altonaga also ordered Tamayo to pay $2.5 million in restitution. Tamayo pleaded guilty in February 2019 to one count of conspiracy to commit health care fraud and wire fraud. Also, Tamayo previously pleaded guilty to conspiracy to pay and receive kickbacks and to defraud the United States.
Tamayo was charged in a December 2018 superseding indictment with charges stemming from her involvement in a Part A home health care and Part B medical services fraud scheme in which she sold medically unnecessary home health care prescriptions to home health agency owners who in turn billed Medicare. According to her admissions made as part of her separate pleas to the health care fraud and kickback conspiracies, Tamayo solicited and accepted kickbacks from patient recruiters and from the owners of several Miami-area home health agencies in exchange for providing prescriptions for home health services to patients at Sunshine. The prescriptions, in turn, were used by the home health agencies to bill Medicare for home health services purportedly provided to Medicare beneficiaries. Tamayo paid a portion of the kickbacks she received from the home health agencies to physicians who worked at Sunshine to induce them to write the fraudulent prescriptions. In addition, Sunshine billed Medicare directly for medical services purportedly provided at the clinic that were not necessary and/or were not provided.
The case was investigated by the FBI, HHS-OIG, and USSS. Trial Attorneys Adam G. Yoffie, Gary A. Winters and Sara Clingan of the Criminal Division’s Fraud Section prosecuted the case. Assistant U.S. Attorney Nalina Sombuntham of the Southern District of Florida handled the asset forfeiture proceedings.
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.