With regard to the home health agency, Prado admits to fraudulent interstate bank wires. In this scenario, Prado and his co-conspirators submit approximately $2.2 million in claims for reimbursement to the Medicare program. The fraudulent claims represent the phony medically necessary home health care benefits prescribed by a doctor, and for Medicare beneficiaries. In reality, however, there are neither medical needs, nor beneficiaries. As a result of the fraudulent claims, Medicare remits payments to the corporate bank accounts of Prado’s home health agency to the tune of approximately $3.9 million.
All-in-all, Prado admits to submitting roughly $7.6 million in fraudulent claims to Florida Blue, along with about $3.9 million in payments from Medicare. As a part of Prado’s fraud plea, he forfeits a myriad of assets, including five homes and high-end jewelry.
