The Department of Justice has announced the owner of Tampa, Florida based Gold Care Home Health Services Inc. (Gold Care), Pilar Garcia Lorenzo (Garcia), was convicted on October 6, 2016, of one count each of conspiracy to commit health care fraud and wire fraud, conspiracy to commit money laundering and money laundering following a jury trial before U.S. District Judge Charlene Edwards Honeywell of the Middle District of Florida.  Her sentencing is scheduled for January 5, 2017.

The evidence presented at trial showed that Gold Care submitted millions of dollars’ worth of false and fraudulent claims to Medicare.  The claims were for home health services that had never been provided and had not been legitimately prescribed by a physician.  As a result of those false and fraudulent claims, Medicare reimbursed Gold Care approximately $2.5 million.  To execute and conceal the fraudulent scheme, Garcia used a “straw” or nominee owner for the home health agency to shield her own involvement. Then Garcia laundered approximately $2 million of the fraud proceeds through fictitious shell companies located in Hialeah, Florida.

This case was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and U.S. Attorney’s Office of the Middle District of Florida.  Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged over 2,900 defendants who collectively have billed the Medicare program for over $10 billion.

The case against Garcia is a criminal case.  However, under the qui tam provisions of the False Claims Act, whistleblowers with information about similar fraud against the government may bring a civil case on behalf of the United States. If successful, the government can recover three times the amount the defendants fraudulently billed the government.  The whistleblower, who originally filed the qui tam case, is entitled to 15-30% of the government’s recovery as well as their attorney’s fees.

Read the full DoJ Press Release