U.S. — South Florida Home Health Owner Charged for Role in $15 Million Medicare Fraud Scheme

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From the Department of Justice news article:

Yunesky I. Fornaris, 38, of Miami, was charged with one count of conspiracy to commit health care fraud and wire fraud, two counts of health care fraud and one count of conspiracy to defraud the United States and pay health care kickbacks.  Fornaris was arrested today and made his initial appearance before U.S. Magistrate Judge William C. Turnoff of the Southern District of Florida.

The indictment alleges that from in or around April 2010 through July 2016, Fornaris and his co-conspirators hid their ownership in Elite Home Care LLC (Elite), a Miami-area home health clinic, in the name of a nominee owner in an effort to conceal their participation in the fraudulent scheme.  According to the indictment, Fornaris and his co-conspirators allegedly submitted false and fraudulent application documents, causing Medicare to give and continue to reauthorize Elite’s Medicare provider number.  As a result, the number enabled Fornaris and his co-conspirators to allegedly submit fraudulent claims for services that were not medically necessary or never provided.  In addition, Fornaris allegedly signed portions of Elite’s Medicare applications and re-certifications committing Elite to comply with Medicare’s rules and regulations, as well as the Federal Anti-Kickback Statute.  Notwithstanding these certifications, Fornaris and his co-conspirators allegedly caused kickbacks to be paid to Medicare beneficiaries and patient recruiters in exchange for the referral of Medicare beneficiaries to Elite.

According to the indictment, Medicare paid approximately $15 million as a result of false and fraudulent claims submitted by Elite…

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