Wisconsin Senior Medicare Patrol

The Department of Justice, the FBI and the Department of Health and Human Services (HHS) together have been investigating the case of $200 Million in fraudulent claims to Medicare under the guidance of American Therapeutic Corporation (ATC); its management company, Medlink Professional Management Group Inc.; and the American Sleep Institute (ASI). Involved in the scheme was Sandra Jimenez, 38. She admitted in a district court in Miami that she conspired to commit health care fraud and that she was involved in paying and receiving illegal health care kickbacks. She admitted to billing for unnecessary Medicare services and recruited beneficiaries to home health who were not actually eligible for the services.  Jiminez’s involvement in multiple schemes accounted for $46 million in fraudulent billings to the Medicare program. Jimenez faces a maximum penalty of 15 years in prison and a $250,000 fine when she is sentenced in June.  The case was investigated by the FBI and HHS-OIG, and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida. The Medicare Fraud Strike Force is charged with looking for other fraudulent providers like Jimenez, who all together, have charged billed more than $2.9 billion to Medicare.

Find more details about this case here.