Two Individuals Convicted of Defrauding Medicaid at a Doral Clinic Providing Psychosocial Rehabilitation Services
Miami, Florida – Two South Florida residents have pleaded guilty to running a mental health care fraud scheme that over-billed Medicaid for hundreds of thousands of dollars.
During the change of plea hearing in federal court in Fort Lauderdale, Florida, Lorena Osella, 44, of Ft. Lauderdale, Florida, pleaded guilty to one count of conspiracy to commit health care fraud, and Juan Luis Matos, 59, of Miami, Florida, pleaded guilty to one count of conspiracy to defraud the United States and to pay health care kickbacks. U.S. District Judge William P. Dimitrouleas, who sits in Ft. Lauderdale, Florida, will sentence both defendants on January 10, 2022.
As part of their guilty pleas, Osella and Matos admitted that they paid kickbacks of $400 in cash per month to Medicaid beneficiaries in exchange for the beneficiaries receiving psychosocial rehabilitation (PSR) services at Lighthouse Community Center LLC, in Doral, Florida. In addition, Osella admitted that she fraudulently billed Medicaid for at least $350,206 in psychosocial rehabilitation (PSR) services that were not provided as claimed. Psychosocial rehabilitation (PSR) services are a type of mental health group counseling designed to help people with depression, anxiety, and other mental disorders cope with their conditions and improve their ability to conduct daily life activities. Medicaid allowed these services to be administered via telemedicine beginning in April 2020 because of the COVID-19 pandemic. Osella and Matos also admitted to illegally receiving Florida unemployment benefits during the time they committed the health care fraud.
HHS-OIG investigated the case. Assistant United States Attorney Timothy Abraham is prosecuting the case. AUSA Emily Stone is handling asset forfeiture.