Doctor guilty in Medicare fraud scheme

Aug. 23, 2011 at 9:35 PM
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MIAMI, Aug. 23 (UPI) -- A Miami-area doctor pleaded guilty Tuesday to his role in a scheme to bilk Medicare out of about $25 million, U.S.prosecutors said.

Jose Nunez, 63, who owns two medical offices, prescribed medically unnecessary services, including home health and therapy prescriptions, care plans and medical certifications, from about January 2006 until about March 2009 in exchange for kickbacks and bribes, the Department of Justice, the FBI and the Department of Health and Human Services announced.

Nunez provided home healthcare and therapy prescription referrals to ABC Home Health Care Inc. and Florida Home Health Care Providers Inc. In plea documents, he admitted he knew the Miami home healthcare agencies billed Medicare for costly physical therapy and home healthcare services that were unnecessary or never provided.

He received kickbacks and bribes from nurses, patient recruiters, and the owners and operators of ABC and Florida Home Health, court documents say.

Nunez pleaded guilty before U.S. District Judge Joan A. Lenard in Miami to one count of conspiracy to commit healthcare fraud.

As part of the scheme, plea documents show, he falsified patient files with descriptions of non-existent medical conditions for the Medicare beneficiaries, including hand tremors, unsteady gait and poor vision.

Sentencing is set for Dec. 5. Conspiracy to commit healthcare fraud carries a maximum prison sentence of 10 years. Nunez also faces fines and forfeiture of any property or proceeds derived from the scheme.

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