On October 3, 2023, a federal jury in Miami convicted a Florida man and woman for their roles in a conspiracy to defraud Medicare by billing over $93 million for home health therapy services that were never rendered.
According to court documents and evidence presented at trial, Karel Felipe, 42, of Miami Shores, and Tamara Quicutis, 54, of Hialeah, conspired with others to submit false bills to Medicare for three home health companies located in Michigan. Their co-conspirators recruited individuals from Cuba to sign Medicare enrollment documents and appear as the owners of the home health agencies to conceal the identities of Felipe, Quicutis, and others involved in the scheme. Felipe, Quicutis, and their co-conspirators used these home health companies to submit claims for services that were not rendered using lists of stolen patient identities. Felipe, Quicutis, and their co-conspirators used hundreds of shell companies and bank accounts to launder the Medicare fraud proceeds and convert the proceeds into cash at Miami-area ATMs and check cashing stores.
After the trial commenced, a third defendant, Jesus Trujillo, 52, of Miami, pleaded guilty to one count of conspiring to commit health care fraud and wire fraud and one count of conspiring to commit money laundering. Trujillo oversaw a group of people that recruited nominee owners for home health agencies and shell companies and converted Medicare fraud proceeds into cash.
The jury convicted Felipe and Quicutis of conspiracy to commit health care fraud and wire fraud, and conspiracy to commit money laundering. They are scheduled to be sentenced on January 4, 2024, and they face a maximum penalty of 20 years in prison on each conspiracy charge. Trujillo is scheduled to be sentenced on December 21, 2023 and faces a maximum penalty of 20 years in prison on each count. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.
Since March 2007, the Health Care Fraud Strike Force Program has charged more than 5,000 defendants who collectively have billed federal health care programs and private insurers more than $24 billion.
If you have information regarding false claims having been submitted to Medicare, Medicaid, TRICARE, other federal health care programs, or to other federal agencies/programs, and the information is not publicly known and no actions have been taken by the government with regard to recovering the false claims, you should promptly consult with a False Claims Act attorney (also known as qui tam attorneys) in your U.S. state who may investigate the basis of your False Claims Act allegations and who may also assist you in bringing a qui tam lawsuit on behalf of the United States, if appropriate, for which you may be entitled to receive a portion of the recovery received by the U.S. government.
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