UNITED STATES DISTRICT COURT

SOUTHERN DISTRICT OF FLO RIDA

Case No.

18 U.S.C. j 1349

18 U.S.C. j 1347

18 U.S.C. j 371

42 U.S.C. j 1320a-7b(b)(1)(A)

18 U.S.C. j 982(a)(7)

18 U.S.C. j 2

UNITED STATES O F AM ERICA

VS.

ER NESTO ESPIN O SA ,

Defendant.

/

INFORM ATION

The United States Attorney charges that:

GENER AL ALLEGATIONS

At al1 times material to this Inform ation:

T he M edicare Proeram

1. The M edicare Program (kéMedicare'') was a federally funded program that provided

free or below-cost health care benefits to certain individuals, primarily the elderly, blind, and

disabled. The benefits available under M edicare were governed by federal statutes and regulations.

The United States Department of Health and Human Services (k1HHS''), through its agency, the

Centers for Medicare and M edicaid Services (û1CM S''), oversaw and administered M edicare.

Individuals who received benefits under M edicare were com monly referred to as M edicare

ûibeneficiaries.''

20-20170-CR-SCOLA/TORRES

May 8, 2020

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CG
2 .

Code, Section 24(b), and a Federal health care program, as defined by Title 42, United States Code,

Section 1320a-7b(9.

M edicare was a tthealth care benefit program,'' as defined by Title 18, United States

M edicare program s covering different types of benefits were separated into different

program tûparts.'' ûûpal't A'' of the M edicare program covered certain eligible hom e health care costs

for medical services provided by a home health agency (i1HHA'') also referred to as a tlprovider,'' 7

to persons who already qualified for M edicare and who additionally required hom e health services

because of an illness or disability that caused them to be hom ebound.

4.

they would abide by the M edicare laws, including the Federal anti-kickback statute, and that they

would not present false or fraudulent claim s for paym ent by M edicare or subm it claim s with

Providers who enrolled in M edicare were required to certify, among other things, that

deliberate ignorance or reckless disregard for their truth or falsity.

5. CM S did not directly pay M edicare Part A claim s submitted by M edicare-certitied

HHAS. CM S contracted with different private companies to adm inister the M edicare Part A

program throughout different parts of the United States. In the State of Florida, CM S contracted

with Palmetto Government Benefits Administrators (ûlpalmetto''). As administrator, Palmetto was

to receive, adjudicate and pay claims submitted by HHA providers under the Part A program for

home health claim s. Additionally, CM S separately contracted with com panies in order to review

HHA providers' claim s data. On Decem ber 15, 2008, CM S contracted w ith SafeGuard Services, a

Zone Program lntegrity Contractor. SafeGuard Senices safeguarded the M edicare Trust Fund by

reviewing HHA providers' claim s for potential fraud, waste, and/or abuse.

Physicians, clinics and other health care providers, including HHA S, that provided

services to M edicare beneficiaries were able to apply for and obtain a tkprovider num ber.'' A health

Case 1:20-cr-20170-RNS Document 1 Entered on FLSD Docket 05/08/2020 Page 2 of 18
care provider that received a M edicare provider number was able to file claim s with M edicare to

obtain reimbursem ent for services provided to beneficiaries. A M edicare claim was required to set

forth, among other thingss the beneficiary's nam e and M edicare information num ber, the services

that were performed for the beneficiary, the date that the services were provided, the cost of the

services, and the name and provider num ber of the physician or other health care provider who

ordered the services.

Part A Coveraze and Rezulations

Reim bursem ents

The M edicare Part A program reimbursed 100% of the allowable charges for

pm icipating HHAS providing home health care services only if the patient qualified for hom e health

benefits. A patient qualified for home health benefits only if the patient:

was confined to the home, also referred to as homebound;

(b) was under the care of a physician who specifically determined there was a need for

home health care and established the Plan of Care (;1POC''); and

(c) the detennining physician signed a certitication statement specifying that the

beneficiary needed interm ittent skilled nursing, physical therapy, speech therapy, or a continued

need for occupational therapy; the beneficiary was contined to the hom e; that a POC for furnishing

services was established and periodically reviewed; and that the senices were furnished while the

benefciary was under the care of the physician who established the POC.

Record Keeping Requirem ents

M edicare Part A regulations required H H A S providing services to M edicare patients

to m aintain complete and accurate medical records retlecting the m edical assessment and diagnoses

of the patients, as well as records documenting the actual treatment of patients to whom services

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were provided and for whom claim s for reimbursement were subm itted by the HHA.

records were required to be sufticiently complete to pennit M edicare, tlurugh Palm etto and other

contractors, to review the appropriateness of M edicare paym ents m ade to the HHA under the Part A

Program .

These medical

9. Am ong the written records required to docum ent the appropriateness of home health

care claims submitted under Part A of Medicare were a (i) POC that included the physician order,

diagnoses, types of services/frequency of visits, prognosis/rehab potential, functional

limitations/activities pennitted, m edications/treatm ents/nutritional requirem ents, safety

measures/discharge plans, goals and the physician's signature; and (ii) a signed certification

statement by an attending physician certifying that the patient was confined to his or her hom e and

was in need of the plnnned hom e health services.

M edicare Part A regulations required provider HHAS to maintain m edical records of

every visit m ade by a nurse, therapist, and hom e health aide to a beneficiary. The record of a nurse's

visit was required to describe, am ong other things, any significant observed signs or symptoms, any

treatment and drugs administered, any reactions by the patient, any instnzction provided to the patient

and the understanding of the patient, and any changes in the patient's physical or em otional

condition. The hom e health nurse, therapist and aide were required to document the hands-on

personal care provided to the beneticiary as the services were deem ed necessary to m aintain the

beneficiary's health or to facilitate treatment of the beneficiary's primary illness or injury. These

written m edical records were generally created and maintained in the form of ûtclinical notes'' and

ûihom e health aide notes/observations.''

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The Defendant. Related Com panies and lndividuals

1 1. General Hea1th M edical, lnc. (tûGeneral Health'') was a Florida corporation

pup ortedly doing business in M iami, Florida.

HHA 1 was a Florida corporation purportedly doing business in M iam i Lakes,

Florida.

HHA 2 was a Florida corporation purportedly doing business in M iami, Florida.

14. HHA 3 was a Florida corporation purportedly doing business in M iam i, Florida.

15. HHA 4 was a Florida corporation purportedly doing business in M iam i, Florida.

l6. HHA 5 was a Florida corporation purportedly doing business in M iam i, Florida.

HHA 6 was a Florida corporation purportedly doing business in M iam i, Florida.

18. HHA 7 was a Florida corporation purportedly doing business in M inmi, Florida.

19. HHA 8 was a Florida corporation purportedly doing business in M iami, Florida.

20. HHA 9 was a Florida com oration purportedly doing business in M iam i, Florida.

21. HHA 10 was a Florida com oration purportedly doing business in Lauderhill, Florida.

22. HHA 1 1 was a Florida com oration purportedly doing business in Hialeah, Florida.

HHA 12 was a Florida corporation pum ortedly doing business in Hialeah, Florida.

24. HHA 13 was a Florida corporation purportedly doing business in M iam i, Florida.

25. Ansi Consulting Services lnc. (:$Ansi'') was a Florida corporation purportedly doing

business in Hialeah, Florida.

26. Exposito Consulting Inc. (ûkExposito'') was a Florida corporation purportedly doing

business in H ialeah, Florida.

Defendant ERNESTO ESPINO SA was the owner and operator of General Health,

Ansi and Exposito.

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28. lndividual l was the owner and president of HHA 1 .

29. Individual 2 was the registered agent of HHA 6 and the operator and true owner of

HHA 8.

30. lndividual 3 was a resident of M iami-Dade County and a M edicare beneficiary.

CO UNT 1

Conspiracy to Com m it Health Care Fraud

(18 U.S.C. j 1349)

The General Allegations section of this lnformation is re-alleged and incorporated

by reference as though fully set forth herein.

From in or around January 2010, and continuing through in or around Jtme 2015, in

M iami-Dade County, in the Southern District of Florida, and elsewhere, the defendant,

ERNESTO ESPINOSA,

did willfully, that is, with the intent to further the object of the conspiracy, and knowingly combine,

conspire, confederate, and agree with lndividual 1, lndividual 2, lndividual 3, and others known

and unknown to the United States Attorney, to knowingly and willfully execute a scheme and

artifice to defraud a health care benefit program affecting comm erce, as defined in Title 18, United

States Code, Section 24(b), that is, Medicare, and to obtain, by means of materially false and

fraudulent pretenses, representations, and promises, money and property owned by, and under the

custody and control of, said health care benefit program, in connection with the delivery of and

paym ent for health care benefits, item s, and services, in violaticm of Title 18, United States Code,

Section 1347.

Purpose of the C onspiracy

It was the purpose of the conspiracy for the defendant and his co-conspirators to

unlawfully enrich themselves by, among other things: (a) submitting and causing the submission of

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false and fraudulent claim s to M edicare, including claim s for hom e health services that were

medically unnecessary, not eligible for Medicare reimbursement, and not provided', (b) concealing

the submission of false and fraudulent claims to Medicare; and (c) diverting fraud proceeds for their

personal use and benefit, the use and benefit of others, and to further the fraud.

M anner and M eans of the Conspiracv

The malmer and m eans by which the defendant and his co-conspirators sought to accomplish

the object and purpose of the conspiracy included, among others, the following:

4. ERNESTO ESPINO SA, lndividual 2, and their co-conspirators paid and caused

the payment of kickbacks and bribes to M edicare beneficiaries, including to Individual 3, to induce

their referral to home health agencies, for home health services that were medically lmnecessary,

not eligible for M edicare reimbursem ent, and not provided.

ERNESTO ESPINO SA, Individual 2, and their co-conspirators, directly and

through General Health, paid doctors who signed false and fraudulent medical records, including

hom e health prescriptions and plans of care, for M edicare beneficiaries recruited by ESPINOSA

and Individual 2.

6. ERNESTO ESPINOSA and lndividual 2 instructed M edicare beneficiaries,

including lndividual 3, on how to obtain false and fraudulent medical records, such as home health

care prescriptions and plans of care from a doctor, including what to say to the prescribing doctor.

7. ERNESTO ESPINO SA solicited and received kickbacks and bribes from home

health agencies, in exchange for referring M edicare beneficiaries that ESPINO SA and Individual

2 recruited for services that were m edically unnecessary, not eligible for M edicare reimbursem ent,

and not provided.

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8. ERNESTO ESPINO SA incorporated and caused to be incorporated Ansi

Consulting and Exposito Consulting for the purpose of concealing, receiving, and paying kickbacks

and bribes solicited and received from home health agencies.

Individual 2 distributed and caused to be distributed the kickback paym ents from

home health agencies to ERNESTO ESPINO SA , directly and through Ansi Consulting and

Exposito Consulting.

10. ERNESTO ESPINO SA, lndividual 2, and their co-conspirators sent the M edicare

beneficiaries that they recruited, including lndividual 3, to multiple home health agencies in order

to receive kickback payments from additional hom e health agencies.

ERNESTO ESPINO SA, lndividual 1, lndividual 2, lndividual 3, and their coconspirators subm itted and caused home health care agencies, including, among others, HHA 1 ,

HHA 2, HHA 3, HHA 4, HHA 5, HHA 6, HHA 7, HHA 8, HHA 9, HHA 10, HHA 1 1, HHA 12,

and HHA 13, to subm it claim s that falsely and fraudulently represented that home health therapies

were medically necessary, prescribed by a doctor, and had been provided to M edicare beneficiaries.

12. ERNESTO ESPINO SA and his co-conspirators used the proceeds from the false

and fraudulent M edicare claims for their own use and benefit, the benefit of others, and to further

the fraud.

A11 in violation of Title 18, United States Code, Section 1349.

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CO UNT 2

H eaIth Carè Fraud

(18 U.S.C. j 1347)

The General Allegations section of the Inform ation is re-alleged and incom orated

by reference as though fully set forth herein.

From in or around January 2010, and continuing through in or around June 2015, in

M iami-Dade County, in the Southel'n District of Florida, and elsewhere, the defendant,

ERNESTO ESPINO SA,

in colmection with the delivery of and paym ent for health care benetits, item s, and services, did

knowingly and willfully execute, and attempt to execute, a schem e and artifice to defraud a health

care benefit progrnm affecting commerce, as defined in Title 1 8, United States Code, Section 24(b),

that is, M edicare, and to obtain, by means of m aterially false and fraudulent pretenses,

representations, and prom ises, money and property owned by, and under the custody and control of

said health care benefit program .

Purpose of the Schem e and Artifice

lt was the purpose of the schem e and artifice for the defendant and his accomplices

to unlawfully enrich themselves by, among other things: (a) submitting and causing the

submission of false and fraudulent claims to M edicare; (b) concealing the submission of false and

fraudulent claims to Medicare; (c) concealing the receipt and transfer of fraud proceeds; and (d)

diverting fraud proceeds for the personal use and benefit of them selves and others, and to further

the fraud.

9

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The Schem e and Artifice

4. The allegations contained in paragraphs 4 through 12 of the M anner and M eans

section of Count 1 of this lnform ation are re-alleged and incorporated by reference as though fully

set forth herein as a description of the schem e and artifice.

Act in Execution or Attem pted Execution of the Schem e or Artifice

On or about June 2,2015, in M iami-Dade County, in the Southern District of

Florida, and elsewhere, ERNESTO ESPINOSA, in connection with the delivery of and paym ent

for health care benefits, item s, and services, did knowingly and willfully execute, and attempt to

execute, the above-described schem e and artitice to defraud a health care benefit program affecting

commerce, as defined by Title 18, United States Code, Section 24(b), that is, M edicare, and to

obtain, by means of m aterially false and fraudulent pretenses, representations, and promises, money

and property owned by, and under the custody and control of, said health care benefit program , in

that the defendant caused the subm ission of false and fraudulent claim num ber

2142950340730712LR seeking $2,420.01, and representing that HHA 4 provided hom e health

senices to lndividual 3, a M edicare beneficiary, pursuant to a physician's prescriptions.

In violation of Title 18, United States Code, Sections 1347 and 2.

COUNT 3

Conspiracy to Defraud the United States and Pay and Receive Health Care K ickbaclts

(18 U.S.C. j 371)

The General Allegations section in this lnformation is re-alleged and incorporated by

reference as though fully set forth herein.

From in or around January 2010, and continuing through in or around M ay 2015, in

M iami-Dade County, in the Southern District of Florida, and elsewhere, the defendant,

ERNESTO ESPINOSA,

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did willfully, that is, with the intent to further the objects of the conspiracy, and knowingly combine,

conspire, confederate, and agree with lndividual 1, lndividual 2, lndividual 3 and others known and

unknown to the United States Attorney:

a.

defeating through deceitful and dishonest m eans, the lawful govenunent ftmdions of the United

States Department of Hea1th and Human Services in its administration and oversight of the M edicare

program in violation of Title 18, United States Code, Section 371, and to comm it an offense against

to defraud the United States by im pairing, im peding, obstructing, and

the United States, that is,

b. to violate Title 42, United States Code, Section 1320a-7b(b)(1)(A), by

knowingly and willfully soliciting and receiving any rem uneration, including kickbacks and bribes,

directly and indirectly, overtly and covertly, in cash and in kind, in return for referring an individual

to a person for the furnishing and arranging for the fum ishing of any item and service for which

paym ent m ay be m ade in whole and in part by a Federal health care program , that is, M edicare.

to violate Title 42, United States Code, Section 1320a-7b(b)(2)(A), by

knowingly and willfully offering and paying any remuneration, including kickbacks and bribes,

directly and indirectly, overtly and covertly, in cash and in kind, to a person to induce such person

to refer an individual to a person for the fum ishing and anunging for the furnishing of any item and

service for which paym ent m ay be made in whole and in part by a Federal health care program , that

is, M edicare.

d.

knowingly and willfully offering and paying any rem uneration, including kickbacks and bribes,

to violate Title 42, United States Code, Section 1320a-7b(b)(2)(B), by

directly and indirectly, overtly and covertly, in cash and in kind, to a person to induce such person

to purchase, lease, order, or arrange for or recom mend purchasing, leasing, or ordering any good,

11

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facility, service or item for which paym ent m ay be m ade in whole and in part under a Federal health

care program , that is, M edicare.

Purpose of the C onspiracv

It was a purpose of the conspiracy for the defendant and his co-conspirators to

unjustly enrich themselves by, among other things: (a) offering and paying kickbacks and bribes in

return for refening Medieare beneficiaries to home health agencies to sel've as patients; (b) soliciting

and receiving kickbacks and bribes in retum for referring M edicare beneficiaries to home health

agencies to serve as patients; (c) concealing and causing the concealment of kickbacks and bribes

and false and fraudulent claim s, including by incorporating or causing the incorporation of shell

companies for the purpose of receiving, concealing,and paying kickbacks and bribes; and (d)

diverting kickback and fraud proceeds for their personal use and benefit, the use and benefit of

others, and to flm her the conspiracy.

M anner and M eans of the Conspiracv

4 .

section of Count 1 of this lnformation are re-alleged and incorporated by reference as though fully

set forth herein as a description of the m nnner and means by which the defendant and his coThe allegations contained in paragraphs 4 through 12 of the M anner and M eans

conspirators sought to accomplish the objects and purpose of the conspiracy in Count 4.

O vert A cts

In furtherance of the conspiracy, and to accomplish its objects and purpose, at least one of

the co-conspirators com mitted and caused to be com mitted, in the Southern District of Florida and

elsewhere, at least one of the following overt acts, am ong others:

12

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1.

2022 in the amount of $4,800 m ade payable to Exposito Consulting as a kickback for refening

M edicare beneficiaries to HHA 1.

On or about M ay 11, 2015, lndividual 1 signed or caused to be signed check number

On or about M ay 1 1, 2015, ERNESTO ESPIN OSA deposited check num ber 2022

in the am ount of $4,800 into account ending in x1474 in the nnm e of Exposito Consulting.

On or about M ay 14, 2015, ERNESTO ESPINO SA withdrew or caused to be

withdrawn $200 in cash from account ending in x1474 in the nam e of Exposito Consulting.

A1l in violation of Title 18, United States Code, Section 371.

CO UNT 4

Receipt of Kickbaclks in Connection with a

Federal H eaIth Care Program

(42 U.S.C. j 1320a-7b(b)(1)(A))

1.

Information are re-alleged and incom orated by reference as though fully set forth herein.

Paragraphs 1-10, 12, 25-28, and 30 of the General Allegations section in this

2. On or about M ay 1 1,2015, in M iami-Dade County, in the Southem D istrict of

Florida, and elsewhere, the defendant,

ERNESTO ESPINOSA,

did knowingly and willfully solicit and receive remuneration, that is, kickbacks and bribes, directly

and indirectly, overtly and covertly, in cash and in kind, including by check num ber 2022 in the

amount of $4,800 drawn on HHA 1 's account ending in x4858 and m ade payable to Exposito

Consulting, in return for refening an individual to a home health agency for the furnishing and

arranging of home health services, for which paym ent may be made in whole and in part by

M edicare.

In violation of Title 42, United States Code, Section 1320a-7b(b)(1)(A), and Title

18, United States Code, Section 2.

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FORFEITURE

(18 U.S.C. j 982(a)(7))

The allegations of this lnfonnation are hereby re-alleged and by this reference fully

incorporated herein for the purpose of alleging forfeiture to the United States of Am erica of certain

property in which defendant, ERNESTO ESPINO SA, has an interest.

2. Upon conviction of a violation of Title 18, United States Codes Sections 371, 1347,

1349 or Title 42, United States Code, Section 1320a-7b as alleged in this Infonnation, the defendant

shall forfeit to the United States any property, real or personal, that constitutes or is derived, directly

or indirectly, from gross proceeds traceable to the comm ission of the offense, pursuant to Title 18,

United States Code, Section 982(a)(7).

lf the property described above as being subject to forfeiture, as a result of any act

or om ission of the defendant,

a.

b.

calm ot be located upon the exercise of due diligence;

has been transferred or sold to, or deposited with a third person',

has been placed beyond the jurisdidion of the Court;

has been substantially dim inished in value; or

has been comm ingled with other property which cannot be

subdivided without difficulty;

d.

e.

the United States shall be entitled to forfeiture of substitute property under the provisions of Title

21, United States Code, Section 853(p).

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Al1 pursuant to Title 18, United States Code, Sections 982(a)(7), and the procedures set forth

in Title 21, United States Code, Section 853, as incorporated by Title 18, United States Code, Section

982(b)(1).

t u) .ù

ARIANA FAJARDO ORSHAN

UN ITED STATES ATTORN EY

SOUTHERN DISTRICT OF FLORIDA

ROBERT ZINK

CHIEF

CRIM INAL DIVISION, FM UD SECTION

U.s. DEPARTM ENT OF JUSTICE

ALLAN M EDW A

DEPUTY CHIEF

CRIM m AL DIV ISION , FRAUD SECTION

U .s. DEPARTM ENT OF JUSTICE

By:

JAM I E B ER

TRIAL ATTORNEY

CRIM INAL DIVISION , FRAUD SECTION

U.s. DEPARTM ENT OF JUSTICE

Case 1:20-cr-20170-RNS Document 1 Entered on FLSD Docket 05/08/2020 Page 15 of 18
UNITED STATES DISTRICT COURT

SOUTHERN DISTRICT OF FLORIDA

UNITED STATES OF AM ERICA C ASE NO .

CERTIFICA TE O F TRIA L A TTO RNEY.

Superseding Case Information:

New defendantts) YeS

N um ber of new defendants

Total number of counts

ERNESTO ESPINO SA,

Defendant. /

Court Division: (select One)

z M iam i Key W est

FTL W PB FTP

I have carefully considered the allegations of the indictm ent, the number of defendants, the number of

probable witnesses and the legal com plexities of the Indictment/lnformation attached hereto.

I am aware that the information supplied on this statement will be relied upon by the Judges of this

Court in setting their calendars and scheduling criminal trials under the mandate of the Speedy Trial

Act, Title 28 U.S.C. Section 3161 .

lnterpreter: (Yes or No) Yes

List language and/or dialect Soanish

This case will take 5 days for the parties to try.

Please check appropriate category and type of offense listed below:

(ciaeck only one) (Check only one)

I 0 to 5 days ?' Petty

11 6 to 10 days M inor

III 1 l to 20 days M isdem.

IV 21 to 60 days Felony ?'

V 6 l days and over

6. Has this case previously been filed in this District Court? (Yes or No) No

lf yes: Judge Case N o.

(Attach copy of dispositive order)

Has a complaint been filed in this matter? (Yes or No) XO

If yes: M agistrate Case No.

Related miscellaneous num bers:

Defendantts) in federal custody as of

Defendantts) in state custody as of

Rule 20 from the District of

Does this case originate from a matter pending in the Central Region of the U .S. Attorney's Office

prior to August 9, 2013 (Mag. Judge Alicia 0. Valle)? Yes No ?

Does this case originate from a matter pending in the Northern Region U.S. Attorney's Office

prior to August 8, 20 14 (Mag. Judge Shaniek M aynard)? Yes No 4

JAIM E E ER

DOJ TRIAL ATTORNEY

COURT ID NO. 5502601

#penalty Sheetts) attached

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UNITED STATES DISTRICT COURT

SOUTHERN DISTRICT O F FLO RIDA

PE-NALT-Y SHKET

Defendant's Nam e: ERNESTO ESPINOSA

C ase N o:

Count #:

Title 18. United States Code. Section 1349

Conspiracv to Com mit Hea1th Care Fraud

*M ax Penpltyu Ten- tlo) vçars' imprisonm ent

Counts #: 2

Title 18. United States Codes Section 1347

Health Care Fraud

*M ax Penaltv: Ten (10) years' imprisonment

Count #:

Title 18. United States Code. Section 371

Conspiracy to Defraud the United States and Pay and Receive Hea1th Care Kickbacks

*M ax Penalt'y: Five (5) years' im prisonm ent

Counts #: 4

Title 42. United States Codes Section 1320a-7b(b)(1)(A)

Receipt of Kickbacks in Connection wiyh a lïqderql Hewtth Cqm Prouram

*M ax Penalty: Ten (10) years' imprisonment

*R efers only to possible term of incarceration, does not include possible fines. restitution,

special assessm ents, parole term s, or forfeitures that m ay be applicable.

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AO 455 (Rev. 01/09) Waiver of an Indictment

U NITED STATES D ISTRICT C OURT

for the

Southern District of Florida

United States of America

V.

Ernesto Espinosa,

Defendant

Case No.

W AIVER OF AN INDICTM ENT

l understand that l have been accused of one or more offenses punishable by im prisonment for more than one

year. I was advised in open court of my rights and the nature of the proposed charges against me.

After receiving this advice, I waive my right to prosecution by indictment and consent to prosecution by

information.

Date:

Signature ofdefendant 's attorney

Printed name ofdefendant 's attorney

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