Loyola University Chicago School of Law, JD 2018
Pillar Garcia Lorenzo, (Lorenzo), former owner of Gold Care Home Health Services (Gold Care) located in Tampa, Florida was convicted by a federal jury on Thursday, October 6th, 2016 due to her role in a conspiracy to commit health care fraud and wire fraud, money laundering and a conspiracy to commit money laundering.
In the summer of the 2014, Gold Care submitted false claims for Medicare reimbursement for health care services that were either not completed, not medically necessary or were not legitimately prescribed by physicians. Medicare reimbursed Gold Care for a total of $2.5 million dollars. Roughly $2 million of the funds were laundered in cash transactions through several fake companies registered in Hialeah, Florida. Furthermore, Lorenzo stole the identities of senior citizens in order to bill Medicare. Amaury Perez, accused of partnering with Lorenzo during the scheme, was also indicted but still remains a fugitive. According to the indictment, both Lorenzo and Perez used the company accounts as their own personal bank accounts, often withdrawing tens of thousands of dollars at a time. Lorenzo will be sentenced on January 5, 2017.
Interestingly enough, less than ten years ago, Perez filed for bankruptcy claiming to make less than $10,000 a year. However, in 2011, Lorenzo bought a home in Tampa in 2011, paid off her mortgage by 2013, and was constantly making renovations and other home improvements. In 2011, Gold Home was formed and operated on West Busch Boulevard in an office building. There was minimal legitimate business taking place in that office.
These criminal charges were a result of the nationwide sweep by the Medicare Fraud Strike Force in summer 2015. Including Perez and Lorenzo, this sweep resulted in 243 charges and more than $712 million in false billing. Established in 2007, the Medicare Fraud Strike Force, which now operates in nine cities, consists of a team of investigators from federal, state and local agencies to combat Medicare fraud committed against the government. Since its creation, it has charged over 2900 defendants who have billed the government for over $10 billion collectively. A majority of these defendants have been convicted.
This was not the last sweep that took place. On June 22, 2016, the Department of Justice released news of a nationwide sweep that resulted in criminal and civil charges against 301 people for their alleged participation in health care fraud schemes that demonstrated roughly $900 million in false billings. This sweep took place in 36 federal districts and was also led by the Medicare Fraud Strike Force.
The government is cracking down on health care fraud, and we can expect that many more cases similar to Lorenzo’s are likely to be investigated.