Rossana Ramirez, a once certified nursing assistant, was discovered to be helping run a business in West Miami-Dade that is responsible for $7 million in health care fraud. After pleading guilty Ramirez was stripped of her license permanently through an Emergency Suspension Order and is now serving time at a federal detention center with a release date of June 2022.
Rossana Ramirez was registered in the state corporation registration as the vice president of a company titled F&E Home Health Care. While Rossana Ramirez is currently taking the heat from the Florida Department of Health, her husband Evelio Ramirez Jr. is also involved as the president of F&E. He will soon be starting his sentence of three years and ten months in federal prison himself. Both husband and wife are 59 and will both serve their time. Their pleas of guiltily were fairly straightforward and show that this act of fraud is not very uncommon from what has already been seen from healthcare fraud schemes in South Florida.
F&E is accused of paying kickbacks, a form of negotiated bribery in which a commission of sorts is given in return for services rendered, to those who receive Medicare and Medicaid to become F&E patients. Additionally, some of these patients did not even require home healthcare and the services promised were not often necessary or even provided at times. F&E is also accused of paying recruiters of Medicare and Medicaid recipients to promote their health services for them.
Healthcare fraud generally revolves around claiming for remeasurements that one is not entitled to. There are a number of different types of healthcare fraud with the same goal of collecting from the state or federally operated systems that are put in place to provide for those in need. Majority of healthcare based fraud is directed at either Medicare or Medicaid, or in this case both, due to the popularity of their relief services.
Blue Cross, a trusted health provider, states “The National Health Care Anti-Fraud Association estimates conservatively that health care fraud costs the nation about $68 billion annually — about 3 percent of the nation’s $2.26 trillion in health care spending. Other estimates range as high as 10 percent of annual health care expenditure, or $230 billion.”
Medicare is a federally operated health care assistance program for those over 65, while Medicaid is a state and federally run operation that helps those with low income. Medicaid in total ended up paying F&E $368,927.56, while Medicare in total paid $7,014,001.46. This left husband and wife with over $7 million each.
Those looking for more information on Medicare fraud and other whistleblower attorney services can learn more from Jeffery Newman Law & The Whistleblower Help Center!