Antonio Olivera, administrator of Southern California-based home health and hospice agency Mhiramarc Management LLC, was sentenced to 30 months in prison for his role in a Medicare fraud scheme involving $28 million in falsified health care claims.
Olivera pled guilty to one count of conspiracy to commit health care fraud in November 2020, resulting in millions of illegal kickbacks paid to local patient referral sources for unnecessary or unprovided hospice services.
“As part of his guilty plea, Olivera admitted that from 2011 to 2018, while acting as administrator for Mhiramarc Management LLC (Mhiramarc), a hospice located in Downey, California, Olivera and others paid illegal kickbacks to patient recruiters for the referral of hospice beneficiaries to Mhiramarc,” the U.S. Justice Department indicated in a statement. “Further, when clinical staff at Mhiramarc determined beneficiary referrals did not qualify to receive hospice services, Olivera overruled those determinations and nonetheless caused the beneficiaries to be put on hospice service.”
Olivera admitted to personal responsibility for more than $4.7 million in false and fraudulent claims to Medicare, which resulted in Mhiramarc receiving nearly $3 million in Medicare payments to beneficiaries for medically unnecessary hospice services. The three other unnamed co-conspirators have also pleaded guilty for their involvement and are currently awaiting sentencing.
The crimes were investigated by the Federal Bureau of Investigation’s Los Angeles Field Office and the Medicare Fund Strike Force, a collaboration of local, state and federal officials coordinated by the U.S. Department of Health & Human Services Office of the Inspector General. Founded in 2007, the strike force has 15 units in 24 districts and has charged more than 4,200 individuals for a total $19 billion in Medicare fraud.
Increased scrutiny is proliferating the hospice industry, as regulatory agencies crack down on organizations nationwide, often trying them under the False Claims Act. In instances like those involving Texas-based Merida Health Group, investigators found that company representatives lied to patients and families about their health status, indicating death was imminent when it was not.
Found guilty for his part in deceiving patients and families, the recent hospice care fraud scheme is not the first conspiracy case brought against Olivera and the Mhiramarc agency. Olivera was previously indicted in September 2019 for his involvement in more than $150 million falsified Medicaid and Medicare claims, according to a report from the Healthcare Fraud Group.
According to the reports, federal and local enforcement worked in conjunction with the Medicare Fraud Strike Force to uncover criminal cases aimed at false debiting of Medicaid, Medicare and additional health care programs for unnecessary and unprovided medical evaluations and services, and prescriptions to beneficiaries.