Three Florida ALF Owners Plead Guilty to Medicare Fraud Schemes

Two Miami-area assisted living facility owners pleaded guilty Friday, October 26, for their role in a Medicare fraud scheme related to a defunct Florida healthcare provider, announced the Department of Justice.

Raymond Rivero and Ivon Perez each pleaded guilty to one count of conspiracy to solicit and receive cash kickbacks from the defunct provider, Health Care Solutions Network (HCSN). 

Rivero, who owned the Miami-based assisted living facility God Is First, and Perez, who owned Kayleen and Denis Care Corp., were indicted for fraud after HCSN obtained ineligible Medicare beneficiaries to attend purported partial hospitalization programs (PHPs). 

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HCSN obtained those beneficiaries by paying kickbacks to owners and operators of area assisted living facilities or otherwise recruiting them from senior care communities, according to court documents. 

Earlier in the week, the owner of another Miami-area assisted living facility, Daniel Martinez, pleaded guilty to one count of soliciting and receiving bribes for his part in the HCSN fraud scheme. 

The ALF residents referred by Rivero, Perez and Martinez were not qualified to be placed in the PHPs and were only chosen because they had Medicare or state of Florida Medicaid benefits. Some of the patients suffered from Alzheimer’s disease, dementia or mental retardation, making them unable to benefit from the programs.

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According to court documents, from 2004 to 201, HCSN billed Medicare and Medicaid approximately $63 million for fraudulent mental health services.

Written by Jason Oliva

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