Emotional Turmoil

Medicare enrollment form and glasses

Antonio Olivera was sentenced for his role in a Medicare fraud scheme that resulted in $28 million in fraudulent claims. Olivera worked as an administrator for a Southern California-based home health and hospice agency, Mhiramarc Management LLC (Mhiramarc), during the time the Medicare fraud scheme occurred. (Unfortunately, some people at the top use their high- ranking positions within an organization to carry out fraud because they somehow rationalize that they are above the law.)

Olivera pleaded guilty to one count of conspiracy to commit healthcare fraud in November 2020. He admitted to being a part of an illegal kickback scheme involving patient referrals for unnecessary hospice services. (So, he not only broke the law, but also took advantage of vulnerable patients who did not need the services prescribed.)

From 2011 to 2018, Olivera and others paid illegal kickbacks to patient recruiters for the referral of hospice beneficiaries to Mhiramarc. When clinical staff at Mhiramarc brought it to Olivera’s attention that some beneficiary referrals did not qualify to receive hospice services, he overruled their objections and placed the beneficiaries on hospice. (Olivera didn’t care about the patients’ quality of care, just how much money he could make off of them.)

Investigators found that company representatives lied to patients and families about their health status by indicating death was imminent, when it was not. This caused patients who were otherwise healthy to be unnecessarily placed on hospice. (He created emotional turmoil for these individuals and their families who thought their days were numbered.)

Olivera admitted to being personally responsible for more than $4.7 million in false and fraudulent claims to Medicare. In total, Mhiramarc received nearly $3 million in Medicare payments for medically unnecessary hospice services.

Olivera was sentenced to 30 months in prison for committing Medicare fraud. This hospice care fraud scheme is not the first conspiracy case brought against Olivera and the Mhiramarc agency. (Somehow, this does not surprise me.) Olivera was previously indicted in September 2019 for his involvement in more than $150 million falsified Medicaid and Medicare claims. (It looks like he didn’t learn his lesson the first time around. Which also doesn’t surprise me.)

There are three other unnamed co-conspirators who have also pleaded guilty for their involvement and are currently awaiting sentencing.

Today’s Fraud of the Day comes from an article, “Mhiramarc Exec Sentenced in $28 Million Hospice Fraud Scheme,” published by Hospice News on February 22, 2021.

Antonio Olivera, administrator of Southern California-based home health and hospice agency Mhiramarc Management LLC, was sentenced to 30 months in prison for his role in a Medicare fraud scheme involving $28 million in falsified health care claims.

Olivera pled guilty to one count of conspiracy to commit health care fraud in November 2020, resulting in millions of illegal kickbacks paid to local patient referral sources for unnecessary or unprovided hospice services.

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Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.