Health care professional pleads guilty to Medicare fraud

On Behalf of | Dec 22, 2013 | Medicare and Medicaid Fraud

Residents of Florida depend on qualified professionals for their health care. The dynamic between patient and provider is necessarily one of trust. That means that providers of health care services and related professionals need to hold to the highest ethical standards. For that reason, locals were shocked when a health care provider pleaded guilty to Medicare fraud in a $63 million dollar scheme.

His guilty plea was announced by an acting assistant attorney general from the Justice Department. A U.S. attorney, the Federal Bureau of Investigation’s special agent in charge, as well as others, were present during the announcement.

The defendant, 50, offered his guilty plea in the Southern District Court of Florida. He had been charged with a single count of conspiracy to commit health care fraud. If convicted, he may face up to 10 years in prison. His sentencing date is set for Feb. 20, 2014.

The defendant worked as a licensed therapist at a mental health facility called HCSN. It provides Partial Hospitalization Services, which are a kind of treatment for mental illness. However, the defendant allegedly knew that HCSN Florida personnel fabricated the medical records of patients on a routine basis.

According to authorities, those records were then used to fraudulently bill government health care programs like Medicaid and Medicare. That billing activity drew the attention of program officials, and an investigation began. When that investigation accumulated sufficient evidence against the defendant, charges were filed.

Accusations of Medicare and Medicaid fraud are very serious due to the potential penalties. Most of these cases receive significant media coverage as well. It’s important to remember that those accused of such crimes are not guilty of the crime until prosecutors prove their guilt beyond a reasonable doubt. Mounting a strong defense is essential in criminal cases such as these.

Source:, “Therapist Pleads Guilty in Miami for His Role in $63 Million Health Care Fraud Scheme” Press Release, Dec. 12, 2013

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