Miami-Based Healthcare Provider Owner Sentenced for $20 Million Medicare Fraud Scheme

Strategic Insights -

Magaly Travieso, 54, of Miami, Florida, was sentenced to nine years' imprisonment for conspiracy to commit healthcare fraud, and Yudorki Ramirez, 53, of Miami, Florida, was sentenced to three years' imprisonment for conspiracy to commit money laundering. The scheme involved submitting over $20 million in fraudulent claims for reimbursement to Medicare, Medicaid, and commercial insurance providers, resulting in over $10 million in payments to ProMed Healthcare, L.L.C., a medical clinic owned by Travieso.

Key Takeaways:

  • Magaly Travieso, owner of ProMed Healthcare, L.L.C., was sentenced to nine years' imprisonment for conspiracy to commit healthcare fraud.
  • Travieso and her co-conspirators submitted over $20 million in fraudulent claims for reimbursement, of which ProMed received over $10 million.
  • The scheme involved paying patients illegal kickbacks and fabricating medical records to substantiate thousands of insurance claims for medically unnecessary goods and services.
  • ProMed's medical records were found to have copied and pasted identical progress notes for multiple patients.
  • Yudorki Ramirez, former spouse of Travieso, was sentenced to three years' imprisonment for conspiracy to commit money laundering.
  • Ramirez laundered over $2 million in health care fraud proceeds into his investment accounts.
  • Law enforcement seized Travieso's 2021 Land Rover Range Rover, over $4 million in health care fraud proceeds from bank accounts belonging to Travieso and Ramirez, and recovered over $2 million in additional forfeited assets.
  • The Court ordered Travieso and Ramirez to pay millions more to the Government and the victims.
  • The case was investigated by the FBI Miami Field Office, the Department of Health and Human Services Office of Inspector General, and the Medicaid Fraud Control Unit of the Florida Office of the Attorney General.

Statistics:

  • Over $20 million in fraudulent claims for reimbursement were submitted to Medicare, Medicaid, and commercial insurance providers.
  • ProMed received over $10 million in payments as a result of the scheme.
  • $75,000 was spent on a 2021 Land Rover Range Rover purchased in the name of ProMed.
  • $750,000 was spent on the purchase of Travieso's residence in Miami, Florida.
  • $141,923.02 was spent on the purchase of Ramirez's residence in Miami.
  • $2,068,904.55 was laundered into Ramirez's investment accounts.
  • Over $6 million in assets were seized or recovered in connection with the scheme.

Sources:

  • Press release from the United States Attorney's Office for the Southern District of Florida.
  • Court documents and information on the website of the District Court for the Southern District of Florida at www.flsd.uscourts.gov or at http://pacer.flsd.uscourts.gov.
  • News article from MIL-OSI Publisher, a New Zealand-based news agency.