Woman Sentenced to Over Six Years in Prison for Role in $4.65 Million Medicare Fraud Scheme

Posted on December 18, 2018 by Medtech[y] Staff

A Florida woman was sentenced to 78 months in prison for her role in a $4.65 million health care fraud scheme involving three home health agencies that purported to provide home health services to Medicare patients.

Margarita Palomino, 54, of Homestead, Florida, was ordered to pay $4,658,241.00 in restitution and to forfeit $186,650.50. Palomino pleaded guilty on Oct. 10, 2018 to one count of conspiracy to commit health care fraud and wire fraud.

Palomino worked at Sunshine Home Health Services Inc., Empire Home Health Agency Inc. and Mildred & Marce Home Health Care Services Inc., all in the Miami area. As part of her guilty plea, Palomino admitted that from approximately January 2010 through approximately January 2014, she accepted kickbacks in return for the referral of Medicare beneficiaries, many of whom did not need or qualify for home health services, to act as patients at the three agencies. Palomino—who was a physician in Cuba but never licensed in the United States—further admitted that she performed home health care nursing visits and prepared related medical records as if she were a licensed medical professional. She also admittedly changed claims coding to increase reimbursement by Medicare.

Palomino admitted that, as a result of false and fraudulent claims submitted as part of this conspiracy, Medicare made payments of at least $4.65 million.

Palomino was charged along with Norma Zayas, 29, of Miami, in an indictment returned on June 7, 2018. Zayas pleaded guilty and is currently awaiting sentencing.

The FBI and HHS-OIG investigated the case, which 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.