A Florida man who formerly owned and managed three Miami-area home health agencies has been sentenced to serve 20 years in federal prison and ordered to pay millions in restitution for his role in a $57 million Medicare fraud scheme. Khaled Elbeblawy was sentenced by U.S. District Judge Beth Bloom. In addition to prison time, he was also ordered to pay $36.4 million in restitution.

Elbeblawy was convicted in January on one count of conspiracy to commit health care fraud and wire fraud, as well as one count of conspiracy to defraud the U.S. and pay health care-related kickbacks. He had been charged in the scheme seven months earlier, being among the 243 people nationwide arrested by the Medicare Fraud Strike Force.

Elbeblawy managed Willsand Home Health Agency Inc. and owned JEM Home Health Care LLC and Healthy Choice Home Services Inc. Prosecutors presented evidence at the trial that between January 2006 and May 2013 Elbeblawy and his co-conspirators used the entities to submit about $57 million in false claims to Medicare, about $40 million of which were actually paid.

The government had alleged that the claims were based on services that patients didn’t medically need and/or were never provided. The patients themselves, according to the government, were procured by paying kickbacks to doctors, patient recruiters and staffing groups.

Cynthia Vilches, the former co-owner of Healthy Choice, is set to be sentenced on Oct. 13, and has pled guilty to one count of conspiracy to commit health care fraud. Elbeblawy’s case was one of the 36 initiated in June 2015 in the Southern District of Florida, part of a far-reaching coordinated sweep that covered 17 federal districts from Florida to Alaska. A wide variety of medical professionals were charged with falsely billing $172 million for Medicare services.

The crackdown involved more than 900 law enforcement personnel and seven states attorneys general and was the largest action ever by the Medicare Fraud Strike Force, which was founded in 2007. Seventy-three of those charged were in the Southern District of Florida, accounting for more than $262.5 million in false billings – 30 percent of the total Defendants and 37 percent of the alleged false claims. Since its inception in March 2007, the Medicare Fraud Strike Force has charged almost 2,900 Defendants who have collectively billed the Medicare program for more than $10 billion.

Source: Law360.com

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