Willsand Home Health Owner Pleads Guilty in $42M Medicare Fraud Scheme
August 02, 2012
The owner and operator of a Miami health care agency pleaded guilty
today for his participation in a $42 million home health Medicare fraud
scheme, announced the Department of Justice, the FBI and the Department
of Health and Human Services (HHS).
Eulises Escalona, 43, pleaded guilty before U.S. District Judge Joan A.
Lenard to one count of conspiracy to commit health care fraud. In
addition, as part of his plea agreement, Escalona agreed to forfeit to
the government two residential properties and cash proceeds of the fraud
contained in several bank accounts.
According to the court documents, Escalona was the owner of Willsand
Home Health Inc., a Florida home health agency that purported to provide
home health care and physical therapy services to eligible Medicare
According to plea documents, Escalona conspired with patient recruiters
for the purpose of billing the Medicare program for unnecessary home
health care and therapy services. Escalona and his co-conspirators paid
kickbacks and bribes to patient recruiters in return for these
recruiters providing patients to Willsand Home Health, as well as
prescriptions, Plans of Care (POCs) and certifications for medically
unnecessary therapy and home health services for Medicare beneficiaries.
Escalona and his co-conspirators would pay kickbacks and bribes directly
to physicians in exchange for those physicians providing home health and
therapy prescriptions, POCs and medical certifications to Escalona and
his co-conspirators. Escalona used these prescriptions, POCs and medical
certifications to fraudulently bill the Medicare program for home health
care services, which Escalona knew was in violation of federal criminal
According to plea documents, at Willsand Home Health, patient files for
Medicare beneficiaries were falsified to make it appear that such
beneficiaries qualified for home health care and therapy services when,
in fact, many of the beneficiaries did not actually qualify for such
services. Escalona knew that in many cases the patient files at Willsand
Home Health were falsified.
From approximately January 2006 through November 2009, Escalona and his
co-conspirators submitted approximately $42 million in false and
fraudulent claims to Medicare and Medicare paid approximately $27
million on those claims.
plea was announced by Assistant Attorney General Lanny A. Breuer of the
Criminal Division; U.S. Attorney Wifredo A. Ferrer of the Southern
District of Florida; Jeffrey C. Mazanec, Acting Special Agent-in-Charge
of the FBI?s Miami Field Office; and Special Agent-in-Charge Christopher
Dennis of the HHS Office of Inspector General (HHS-OIG), Office of
Investigations Miami Office.
This case is being prosecuted by Senior Trial Attorney Joseph S.
Beemsterboer of the Criminal Division?s Fraud Section. 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
Since its inception in March 2007, the Medicare Fraud Strike Force, now
operating in nine cities across the country, has charged more than 1,330
defendants who have collectively billed the Medicare program for more
than $4 billion. In addition, HHS?s Centers for Medicare and Medicaid
Services, working in conjunction with HHS-OIG, is taking steps to
increase accountability and decrease the presence of fraudulent