To serve 68 months in prison for her role in a fraud scheme
that resulted in more than $63 million in fraudulent claims to Medicare and
Florida Medicaid, A former office manager at the defunct health care provider
Health Care Solutions Network Inc. (HCSN) was sentenced today in Miami.
Acting Assistant Attorney General Mythili Raman of the
Justice Department’s Criminal Division; U.S. Attorney Wifredo A. Ferrer of the
Southern District of Florida; Special Agent in Charge Michael B. Steinbach of
the FBI’s Miami Field Office; and Special Agent in Charge Christopher B. Dennis
of the U.S. Department of Health and Human Services Office of Inspector General
(HHS-OIG) Office of Investigations, Miami office, made the announcement.
Forty five year old Lisset Palmero of Miami was sentenced by
U.S. District Judge Cecilia M. Altonaga in the Southern District of
Florida. Palmero was also added prison
term of three years of supervised release and ordered to pay restitution in the
amount of $17.4 million.
Palmero was employed as a receptionist and office manager at
HCSN of a mental health facility that purported to provide Partial
Hospitalization Program (PHP) services during the course of the
conspiracy. A PHP is a form of intensive
treatment for severe mental illness.
HCSN of Florida (HCSN-FL) operated community mental health
centers at two locations. According to
court documents, Palmero was aware that HCSN-FL paid illegal kickbacks to
owners and operators of Miami-Dade County Assisted Living Facilities (ALF) in
exchange for patient referral information to be used to submit false and
fraudulent claims to Medicare and Medicaid. Palmero also knew that many of the
ALF referral patients were ineligible for PHP services because they suffered
from mental retardation, dementia, or Alzheimer’s disease.
Court documents expose that Palmero was aware that HCSN-FL
personnel were fabricating patient medical records. Many of these medical records were formed
weeks or months after the patients were admitted to HCSN-FL for purported PHP
treatment. Palmero was also aware that medical records were fabricated for
“ghost patients” who were never admitted to the HCSN-FL PHP. During her
employment at HCSN-FL, Palmero actively concealed the production of medical
records by preparing, and causing others to prepare, documentation that was
later used to support false and fraudulent billing to government-sponsored
health care benefit programs, counting the Medicare and Florida Medicaid.
According to court documents, from 2004 through 2011, HCSN
billed Medicare and the Florida Medicaid program approximately $63 million for
purported HCSN-FL mental health services.
The FBI and HHS-OIG and was brought as part of the Medicare
Fraud Strike Force, under supervision of the Criminal Division’s Fraud Section
and the U.S. Attorney’s Office for the Southern District of Florida are
investigating this case. Trial Attorney
Allan J. Medina and former Special Trial Attorney William J. Parente prosecuted
the case.
The Medicare
Fraud Strike Force is now working in nine cities in the country, have charged
more than 1,500 defendants who have collectively billed the Medicare program
for more than $5 billion since its inception in March 2007. And also, HHS’s Centers for Medicare &
Medic aid Services, working in conjunction with HHS-OIG, is taking steps to
increase accountability and decrease the presence of fraudulent providers.
