Massive Nationwide Health Care Fraud Takedown

Florida Attorney General
Florida Attorney General
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Massive Nationwide Health Care Fraud Takedown

TALLAHASSEE, Fla.––Attorney General Pam Bondi’s Medicaid Fraud Control Unit, the United States Department of Justice, the Federal Bureau of Investigation and the U.S. Department of Health and Human Services today announced a nationwide health care fraud take down stopping schemes defrauding Medicare and Medicaid out of $2 billion. Nationally, 601 defendants have been charged, including more than 165 doctors, nurses and other licensed medical professionals in schemes involving approximately $2 billion in false billings. As a result of the nationwide operation Florida’s MFCU, working with federal agencies, arrested five individuals on charges involving more than $12.5 million in fraudulent billing, and brought several additional local cases.

“Health care fraud costs taxpayers billions of dollars, increases medical costs and even helps fuel the national opioid crisis. As part of this massive nationwide effort, we were able to arrest some of the worst offenders and stop the illegal sale of prescription opioids—and hopefully safe lives,” said Attorney Pam Bondi.

As part of the nationwide takedown, Florida’s MFCU, FBI, and HHS-OIG arrested Evelio Ramirez, 58, and Rosana P. Ramirez 58, for defrauding the Medicaid and Medicare programs while working at F&E Home Health Care, Inc., a home health agency in Miami. The defendants allegedly defrauded Part A of the Medicare program out of more than $7 million and Medicaid out of more than $368,000 by billing for home health services never provided to beneficiaries, as well as paying kickbacks to patient recruiters in exchange for patient referrals. U.S. Attorney Miesha Shonta Darrough will prosecute the case.

In another Florida case that is part of the nationwide effort, the MFCU, FBI, the U.S. Department of Defense Office of Inspector General Defense Criminal Investigative Service and HHS-OIG arrested Stephen Chalker, 42, of Wellington, Christopher Liva, 39, of Boca Raton and Elaina Liva, 66, of Pompano Beach for conspiracy to commit health care fraud. Chalker is also charged with three counts of health care fraud. According to the indictment, the Livas owned and operated Pop’s Pharmacy, LLC where Chalker worked as a pharmacist. The defendants allegedly submitted false and fraudulent claims to Medicare, TRICARE and Medicaid for compounded drugs and other prescription medications, including expensive pain and scar creams, deemed not medically necessary or never provided. As a result of these false and fraudulent claims, Medicare, TRICARE and Medicaid made payments totaling more than $5 million. DOJ will prosecute the case.

For more on the joint nationwide efforts, click here.

The operation also included the extradition of Kathy Olsen, Escambia County, for exploitation of an elderly resident. The MFCU investigation revealed that the defendant defrauded the victim out of more than $30,000. Olsen is charged with one count of exploitation of the elderly more than $10,000, a second-degree felony. The Attorney General’s Office, through an agreement with the State Attorney’s Office for the First Judicial Circuit will prosecute this case.

Additionally, Sherry Kern, 54, of Baton Rouge, La., awaits extradition to Escambia County, for exploitation of an elderly Floridian. The MFCU investigation revealed that the defendant fraudulently removed more than $340,000 from the victim’s bank and investment accounts. Kern is charged with exploitation of the elderly over $50,000, a first-degree felony. The Attorney General’s Office, through an agreement with the State Attorney’s Office for the First Judicial Circuit.

MFCU’s Federal Operations Bureau works closely with the South Florida Medicare Fraud Strike Force. The Medicare Fraud Strike Force operations are part of a joint initiative between the DOJ and HHS to prevent and deter fraud and enforce current anti-fraud laws around the country. The Medicare Fraud Strike Force operates in nine locations nationwide.

The Florida Attorney General’s Medicaid Fraud Control Unit investigates and prosecutes providers that intentionally defraud the state’s Medicaid program through fraudulent billing practices. Medicaid fraud essentially steals from Florida’s taxpayers. From Jan. 2011 to the present, Attorney General Bondi’s MFCU has obtained more than $851 million in settlements and judgments. Additionally, the MFCU investigates allegations of patient abuse, neglect, and exploitation in facilities receiving payments under the Medicaid program. In 2017, the MFCU was awarded the Inspector General’s Award for Excellence in Fighting Fraud, Waste and Abuse. This award is presented annually to the nation’s top MFCU by the U.S. Department of Health and Human Services Office of Inspector General.