Owners of Miami Home Health Agencies Sentenced in $48 Million Fraud Scheme

The owners and operators of two Miami health care agencies were sentenced to a combined total of more than 13 years for their roles in a $48 million home health Medicare fraud scheme, according to the Department of Justice (DOJ).

Both of the Miami-Dade area, Rogelio Rodriguez, 43, and Raymond Aday, 48, were both sentenced to 108 months and 51 months, respectively, by U.S. District Judge Federico A. Moreno. 

Rodriguez was the owner of both Caring Nurse Home Health Corp. and Good Quality Home Health Inc. 

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Aday was a manager at Caring Nurse and owner of Good Quality.

From January 2006 through June 2011, Caring Nurse and Good Quality submitted approximately $48 million for services that were not medically necessary or were not provided, DOJ notes.

Rodriguez and Aday conspired with patient recruiters for the purpose of billing Medicare for unnecessary home health care and therapy services, according to court documents, which also say both defendants paid kickbacks and bribes to recruiters. 

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Nurse and office staff at both Caring Nurse and Good Quality, reports DOJ, falsified patient files to make it appear the Medicare beneficiaries qualified for services they did not.

In addition to the prison term, Judge Moreno sentenced Rodriguez to pay $33 million in restitution, and Aday to pay $2.1 million for the scheme that billed Medicare for unnecessary home health and therapy services. 

Both defendants were also sentenced to serve three years of supervised release as well as paying a fine of $100,000. 

Written by Jason Oliva