Nestor’s Health Services, Inc. is now non-operational. This seems to be the story with most articles I’ve featured on my blog dealing with Health Care Fraud that’s taken place in the South Florida area over the past year. The word “defunct” seems to come up a lot.
With this latest article, the total amount of money I’ve reported which has been reimbursed by Medicare for fraudulent billing is fast approaching the $100 million dollar mark. But in all fairness, one of the stories posted here involved a reimbursement of $33 million by itself. So when Cruz Sonia Collado, the owner/operator of Nestor’s admitted to swindling Medicare out of $6.5 Million it seemed to be a small portion of the overall pot.
And that’s just a minuscule cut of the more than $100 billion (with a B) dollars in fraudulent claims paid out by Medicare to the dark side of the health care industry on an annual basis. And those in the know say that the actual total may be three times that amount.
But even looking at the big picture, the government still doesn’t take kindly to instances of finding owners of Home Health Care Companies ripping off the federal health insurance program.
This particular case handed down justice rather quickly. It was only three months ago when federal authorities, in a nation-wide sting charged fifty residents of the Sunshine State for various Medicare fraud swindles. The total amount of persons charged across the country added up to ninety, of which sixteen were doctors, leaving South Florida Health Care Executives and associated workers as the area with the most, accounting for more than half of the suspects that were rounded up in May.
Tallying it up, twenty-six individual criminal cases were files with a total of close to seventy- million dollars in fraudulent Medicare claims involved. Cruz Sonia Collado was one of the many caught in the widespread net.
Yesterday, Collado pleaded guilty to one count each of conspiracy to offer and pay health care kickbacks and offering and paying health care kickbacks in front of U.S. District Judge Robert N. Scola in Florida Federal Court. The sum of the submissions to Medicare by Collado’s company totaled $6.5 million of which $6.1 million was paid out over a five year period between 2009 and this current year.
The investigation was conducted by the Federal Bureau of Investigation (FBI) in tandem with the Office of Inspector General, Department of Health & Human Services (HHS-OIG) and was brought as part of the Medicare Fraud Strike Force. Locally, it was under the direction of the Criminal Division’s Fraud Section as well as the U.S. Attorney’s Office for the Southern District of Florida.
Since the Medicare Fraud Strike Force was sanctioned seven years ago, it has charged more than 1,800 suspects who have as a group fraudulently billed Medicare for over $6 billion.
To find out more about this topic, and read more about it, click here to go to the general Fraud Cases page on my Website.
To read about my qualifications and what you should do if you are arrested and charged with this or any other crime, click here.
There are a myriad of fraud cases which can be bought in both the State and federal Courts for instance, fraud can be charged as a simple third degree felony in Florida for which a defendant can face up to five years maximum in jail or the fraudulent conduct involved may be charged as an organized scheme to defraud and depending on the amount involved may result in a statutory maximum punishment of 15 or 30 years in jail
In the federal courts fraud can be brought under the mail fraud, wire fraud securities fraud or bank, mortgage or housing fraud statutes. The elements of such crimes can be based upon a scheme to defraud where the wires (i.e. telephone computers and the like) are used or mail fraud (where the mail is used to perpetuate the fraud). Securities fraud charges can result from pump and dump schemes where based on false information an individual may circulate fraudulent news on the internet about a stock to “pump” up its value and then dump it after he has purchased the inflated stock at a discounted value well before the majority of investors are hurt while the fraudulent actor makes out “like a bandit” with the profit from the grossly inflated stock price.