REPORT: Clinic owner sentenced to prison for multi-million dollar health care fraud scheme

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The Department of Justice announced in a press release Friday the sentencing of a Florida man for a massive health care fraud scheme which ripped off Blue Cross Blue Shield Insurance Company, along with the U.S. Medicare program.

A Miami, Florida man was sentenced to 97 months in prison today for his role in an approximately $10 million health care fraud scheme involving a now-defunct home health clinic and two sham physical rehabilitation clinics located in Miami.

Vladimir Prado Sr., 52, was sentenced by U.S. District Judge Robert N. Scola of the Southern District of Florida.  Judge Scola also ordered Prado to serve three years of supervised release following his prison sentence and pay $4,001,499 in restitution, jointly and severally with his co-defendants.  Prado pleaded guilty on Feb. 2, to one count of conspiracy to commit health care fraud and wire fraud charged in an October 2017 superseding indictment and to one count of conspiracy to commit health care fraud and wire fraud charged in a November 2017 indictment.

In connection with the October 2017 charges, Prado admitted that he owned a Miami medical clinic that submitted approximately $5 million in false and fraudulent claims to Blue Cross Blue Shield, resulting in payments to the clinic totaling approximately $2.6 million.

In connection with the November 2017 charges, Prado admitted that he was a co-owner of a Miami rehabilitation clinic that submitted approximately $2.6 million in false and fraudulent claims to Blue Cross Blue Shield, resulting in payments to the clinic totaling approximately $1.4 million.  Prado further admitted that he also provided the money to purchase a fraudulent home health agency. 

Prado also admitted that from December 2012 through April 2014, he and his co-conspirators submitted to the Medicare program, via interstate wires, approximately $2.2 million in claims for reimbursement, which falsely and fraudulently represented that various home health care benefits were medically necessary, prescribed by a doctor and provided to Medicare beneficiaries.  As a result of these false and fraudulent claims, Medicare made payments to the corporate bank accounts of the home health agency in the approximate amount of $3.9 million, Prado admitted.

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