Florida Business Owners Sentenced in Wide-Ranging Home Healthcare Fraud Scheme

A Florida man and woman will spend years behind bars for their role in a home healthcare fraud scheme that used stolen patient data and spanned from the U.S. to Cuba.

Earlier this month, Karel Felipe, 42, of Miami Shores, was sentenced to eight years and four months in prison. Tamara Quicutis, 54, of Hialeah, was sentenced to five years and 10 months in prison for defrauding Medicare by billing more than $93 million for home health therapy services that were never provided using lists of stolen patient identities including patients who had died.

The two were found guilty by a jury in October of conspiring to commit healthcare fraud and wire fraud and conspiring to commit money laundering.

How the Home Healthcare Fraud Scheme Worked

Defendants and their co-conspirators were involved in what is known as a Medicare fraud “bust-out” scheme involving home health agencies. In a bust-out scheme, each of the fake companies bill as much as possible before authorities catch on. Shell companies become a tool that helps keep the fraudsters ahead of investigators. Shell companies are paper-only firms with no real operations.

In this home healthcare fraud Felipe and Quicutis relied on three home health agencies (HHAs) in Michigan, which they allegedly purchased and enrolled in Medicare under the name of nominee owners. Those companies – Care, Nu-Wave and Tri-County — operated in Michigan from October 2016 to May 2019. The nominee owners, who were unrelated third parties, allegedly had strong ties to Cuba.

Medicare paid the HHAs more than $53 million for the sham claims. That money was then funneled through multiple layers of shell companies and bank accounts. Later, “money mules” were used to convert the funds to cash at ATMs and check-cashing stores around Miami, as well as in Illinois and Michigan, according to court documents.

Additional Defendants

Another defendant, Jesus Trujillo, 52, of Miami, previously pleaded guilty to one count of conspiring to commit healthcare fraud and wire fraud and one count of conspiring to commit money laundering.

Trujillo oversaw a group of people who recruited nominee owners for home health agencies and shell companies and converted Medicare fraud proceeds into cash. He was sentenced to 14 years in prison. The court also entered a forfeiture money judgment against him for the amount involved in money laundering, $44,351,817, and ordered him to forfeit two properties to satisfy that judgment.

Others involved in the home healthcare fraud scheme include Didier Arcia, 44, of Davenport, who was sentenced to six years and eight months in prison after pleading guilty to conspiracy to commit money laundering. Alexey Gil, 41, of Miami, who was sentenced to five years and five months in prison after pleading guilty to conspiracy to commit healthcare fraud and wire fraud. And, Jeffrey Avila, 33, also of Miami, who was sentenced to time served and supervised release after pleading guilty to conspiracy to commit money laundering.

Florida Ground Zero for Healthcare Fraud

A report by CNBC last year found Florida is “ground zero” for healthcare fraud. Taxpayers are losing more than $100 billion a year to Medicare and Medicaid fraud, according to estimates from the National Health Care Anti-Fraud Association.

Our firm represents healthcare professionals in state and federal court who are charged with fraudulent billing, kickbacks, Medicare and Medicaid fraud and false claims, among others. For more information, contact us at 305-358-4500 or email info@vitalehealthlaw.com.