Attorney General Pam Bondi’s Medicaid Fraud Control Unit, the Kissimmee Police Department, the Orlando Police Department and the Osceola County Sheriff’s Office announced the arrests of three individuals for allegedly defrauding the Medicaid program out of more than $10,000. According to the investigation, the owner of Genesis TCM, a provider of Targeted Case Management services and two Genesis employees, allegedly billed Medicaid for Targeted Case Management services never provided. The defendants allegedly conspired with Tranquility HealthCare Solutions owner, Christina M. Benson, and others to fraudulently bill the Medicaid system.
“My Medicaid Fraud Control Unit works tirelessly to recover stolen Medicaid funds and we will not stand for anyone taking advantage of homeless individuals to essentially steal from taxpayers,” said Attorney General Bondi. “Since taking office we have recovered more than $689 million in Medicaid fraud settlements and judgments, and we will continue to aggressively pursue anyone who attempts to steal from the Medicaid program.”
In 2015, authorities arrested the additional conspirators for allegedly recruiting the homeless to bilk Medicaid out of more than $200,000. For more information on these previous arrests, click here.
The Attorney General’s MFCU began investigating Genesis after learning that Genesis did not provide TCM services to Medicaid recipients, including the homeless. According to the investigation, Genesis promised temporary free housing to these recipients, however once recipients filled out free housing forms, Genesis provided limited or no further contact. Genesis allegedly used the recipients’ Medicaid information listed on the forms to bill for TCM services.
Authorities arrested the following defendants in connection to the case:
- Deborah Del-Moral, 55, Orange County;
- Humberto Javier Santiago, 36, Osceola County; and
- Humberto Santiago, 38, Orange County.
All three defendants face one count of Medicaid provider fraud, a second-degree felony, and one count of organized scheme to defraud, a third-degree felony. If convicted, each defendant faces up to 30 years in prison and more than $15,000 in fines. The Medicaid Fraud Control Unit investigated the case.
The Florida Attorney General’s Medicaid Fraud Control Unit investigates and prosecutes providers that intentionally defraud the state’s Medicaid program through fraudulent billing practices. Medicaid fraud essentially steals from Florida’s taxpayers. From Jan. 2011 to the present, Attorney General Bondi’s MFCU has obtained more than $689 million in settlements and judgments. Additionally, the MFCU investigates allegations of patient abuse, neglect, and exploitation in facilities receiving payments under the Medicaid program.