A Hialeah councilwoman and owner of a drug and alcohol rehab center is facing charges that she and others engaged in a healthcare kickback scheme that resulted in the submission of more than $19 million in fraudulent insurance claims.
Angelica Pacheco, owner and operator of Florida Life Recovery and Rehabilitation LLC, was indicted by a Miami grand jury late last month on one count of conspiracy to commit healthcare fraud and wire fraud, five counts of healthcare fraud and two counts of wire fraud. In addition to being indicted, Gov. Ron DeSantis issued an order suspending her from office.
Part of National Healthcare Fraud Crackdown
Pacheco was one of 38 defendants charged in connection with alleged healthcare fraud schemes prosecuted in the Southern District of Florida as part of the Justice Department’s 2024 National Health Care Fraud Enforcement Action.
In all, 193 defendants were charged across the country for their alleged participation in healthcare fraud and opioid abuse schemes that resulted in the submission of more than $2.75 billion in alleged false billings.
The defendants allegedly defrauded programs entrusted for the care of the elderly and disabled to line their own pockets, and the government, in connection with the enforcement action, seized over $231 million in cash, luxury vehicles, gold, and other assets.
The Indictment
According to the Pacheco indictment, from July 2017 through August 2020, Pacheco, a registered nurse, and her co-conspirator, identified as individual one “offered and paid kickbacks and bribes in the form of money, gift cards, free interstate flights, allowing one patient to ‘piggyback’ on another patient’s insurance, and offering other ‘scholarships’ in exchange for a patient referring other individuals with insurance (including individuals covered by the insurance plans).”
Individual One
The indictment identifies individual one as the medical director for Florida Life. According to public records, Jose Santeiro held that position. In 2022, Santeiro was convicted following a 15-day trial of engaging in a scheme that fraudulently billed approximately $112 million for substance abuse services that were never provided or were medically unnecessary at two other rehab facilities — Second Chance Detox LLC, dba Compass Detox and WAR Network LLC a related outpatient treatment program. Santeiro is currently serving a 54-month prison sentence.
The indictment alleges that Pacheco and her co-conspirators entered into agreements with laboratories in Miami-Dade, Broward and Pennsylvania to send urine samples for testing in return for referring patients to Florida Life.
Recycling Patients
In addition, she and her co-conspirators are alleged to have entered into referral agreements with other substance abuse treatment centers that involved recycling the same patients back and forth through the different treatment centers, regardless of medical, necessity so that they could continue to bill for their care.
To keep those patients at Florida Life, it’s alleged that Pacheco and her co-conspirators prescribed, caused to be prescribed and administered medications, including controlled substances, prescription medications and over-the counter medications that “grossly diverged from legitimate medical practice, and which were intended to offer patients a substitute for a narcotic or alcohol induced high.,” the indictment alleges.
South Florida historically has been a hotbed of illegal activity relating to drug and alcohol abuse treatment. In fact, the term “Florida shuffle” was coined to describe substance abusers who come to Florida to get clean, leave treatment, continue using and come back again, all the while having their treatment paid for by insurance.
Pacheco Denies Allegations
In addition to the healthcare fraud charges, the indictment also alleges that Pacheco defrauded the Paycheck Protection Program by making false representations resulting in loans of $150,000 and $86,326.
In a news conference following her arrest, Pacheco denied that she was involved and said her indictment was retribution by Hialeah’s mayor “for the corruption and misconduct” she has been exposing.
How We Can Help
As evidenced by the most recent crackdown, the federal government has made it clear that targeting healthcare fraud is a top priority. Should you find yourself the target of an investigation, having an experienced healthcare lawyer on your side is imperative.
For more than 30 years, The Health Law Offices of Anthony C. Vitale has been representing clients under investigation by local, state and federal agencies. We can provide the support and guidance you need to protect your practice, your reputation, and maintain your professional integrity.
For more information you can contact us at 305-358-4500 or send us an email to info@vitalehealthlaw.com and let’s discuss how we might be able to assist you.
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