Director Of Nursing Sentenced To 57 Months In Prison For Role In $7 Million Health Care Fraud Scheme

Here’s another case where at least some patients cooperated with a Medicare fraud scheme that involved falsifying their records. Do they not realize the risks they face by having inaccurate information in their records?  And why aren’t they prosecuted as co-conspirators?

A former Director of Nursing was sentenced to serve 57 months in prison today for his participation in a $7 million health care fraud scheme involving defunct home health care company Anna Nursing Services Corp. (Anna Nursing).

Armando Buchillon, 42, of Hialeah, Florida, was also sentenced to serve three years of supervised release and ordered to pay $1,896,739 in restitution following his July 29, 2014, guilty plea to one count of conspiracy to commit health care fraud. U.S. District Judge Joan A. Lenard in the Southern District of Florida imposed the sentence.

According to Buchillon’s plea agreement and supporting factual proffer, Buchillon was a Director of Nursing at Anna Nursing, a Miami home health care agency that purported to provide home health and therapy services to Medicare beneficiaries. As part of the fraudulent scheme, Buchillon and his co-conspirators regularly falsified patient documentation in order to make it appear that beneficiaries qualified for and received home health care services, when, in fact, many of the beneficiaries did not actually qualify for or receive such services. This false documentation was submitted to Medicare to support the fraudulent reimbursement claims. In addition, Buchillon paid kickbacks and bribes to patient recruiters in return for the recruiters providing patients to Anna Nursing for services that were medically unnecessary or were not provided. Buchillon also worked as a patient recruiter for Anna Nursing and was paid kickbacks and bribes by the owner of Anna Nursing.

From October 2010 through April 2013, Anna Nursing was paid by Medicare approximately $7 million for fraudulent claims for home health care services.

The case was investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida. This case is being prosecuted by Trial Attorneys Anne P. McNamara and A. Brendan Stewart of the Criminal Division’s Fraud Section.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged nearly 2,000 defendants who have collectively billed the Medicare program for more than $6 billion. In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to: www.stopmedicarefraud.gov.

SOURCE: U.S. Attorney’s Office, Southern District of Florida

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