Thursday, April 26, 2018

Miami Man Sentenced to More Than Eight Years in Prison for Role in $10 Million Health Care Fraud Scheme

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It amazes me often, how brazen and yet how foolish law breakers can be.  I’m not talking about the guy who robs the gas station while wearing his name tag from work (although that applies as well).  No, talking about healthcare providers that brazenly ripoff the system, frequently to the tune of millions, and expect not to get caught.  As someone who is licensed to practice dentistry in two states, I expect my fellow healthcare providers to be the very best they can be.  That’s what is expected of us by our patients.  Unfortunately, not everyone who cares for others has that same interest as their personal guide.
 
Take for instance Vladimir Prado.  He owned a Miami medical clinic and a Miami rehabilitation clinic.  Through those two enterprises, he managed to fraudulently bill for approximately 10 million dollars of treatment. That’s right, 10,000,000 dollars.  Needless to say, when you are billing those kinds of numbers, the federal government pays close attention.  That’s why Vladimir Prado is going to be spending the next 8 years behind bars and paying of 4,000,000 dollars in restitution.
 
Here’s the full rundown, courtesy of the Department of Justice:
 

A Miami, Florida man was sentenced to 97 months in prison today for his role in an approximately $10 million health care fraud scheme involving a now-defunct home health clinic and two sham physical rehabilitation clinics located in Miami. 

Acting Assistant Attorney General John P. Cronan of the Justice Department’s Criminal Division, U.S. Attorney Benjamin G. Greenberg of the Southern District of Florida, Special Agent in Charge Robert F. Lasky 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.

Vladimir Prado Sr., 52, was sentenced by U.S. District Judge Robert N. Scola of the Southern District of Florida.  Judge Scola also ordered Prado to serve three years of supervised release following his prison sentence and pay $4,001,499 in restitution, jointly and severally with his co-defendants.  Prado pleaded guilty on Feb. 2, to one count of conspiracy to commit health care fraud and wire fraud charged in an October 2017 superseding indictment and to one count of conspiracy to commit health care fraud and wire fraud charged in a November 2017 indictment. 

In connection with the October 2017 charges, Prado admitted that he owned a Miami medical clinic that submitted approximately $5 million in false and fraudulent claims to Blue Cross Blue Shield, resulting in payments to the clinic totaling approximately $2.6 million.   

In connection with the November 2017 charges, Prado admitted that he was a co-owner of a Miami rehabilitation clinic that submitted approximately $2.6 million in false and fraudulent claims to Blue Cross Blue Shield, resulting in payments to the clinic totaling approximately $1.4 million.  Prado further admitted that he also provided the money to purchase a fraudulent home health agency.  Prado also admitted that from December 2012 through April 2014, he and his co-conspirators submitted to the Medicare program, via interstate wires, approximately $2.2 million in claims for reimbursement, which falsely and fraudulently represented that various home health care benefits were medically necessary, prescribed by a doctor and provided to Medicare beneficiaries.  As a result of these false and fraudulent claims, Medicare made payments to the corporate bank accounts of the home health agency in the approximate amount of $3.9 million, Prado admitted. 

The cases were investigated by the FBI, HHS-OIG and USSS and were brought by the U.S. Attorney’s Office for the Southern District of Florida and by the Criminal Division’s Fraud Section, as part of the Medicare Fraud Strike Force.  Trial Attorney Adam G. Yoffie of the Fraud Section and Assistant U.S. Attorney Christopher J. Clark of the Southern District of Florida are prosecuting the case.

The Medicare Fraud Strike Force operations are 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.  The Medicare Fraud Strike Force operates in nine locations nationwide.  Since its inception in March 2007, the Medicare Fraud Strike Force has charged over 3,500 defendants who collectively have falsely billed the Medicare program for over $12.5 billion. 

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