Defendant Acquitted of Healthcare Fraud

Guerrero-verdict.jpg Yeleiny Guerrero was the co-owner of Denis Medical Services, Inc. She was charged in a 6 count indictment with conspiracy to defraud the United States by causing the filing of false Medicare claims, conspiracy to commit health care fraud and 4 counts of health care fraud. Her codefendants were Ramon Oscar Soto, Araelia Nieto and Rafael Moreno. Soto was the leader of the charged conspiracy which involved three separate DME companies: P & A Medical, ROS Medical and Denis Medical Services. Nieto and Moreno were co-owners of the other two DME companies. All three of them pleaded guilty and were sentenced to time in the federal pokey: Moreno 18 months, Nieto 24 months and Soto 37 months.
The evidence at trial demonstrated that Guerrero established the corporation in her name, opened a bank account as the sole signatory, applied for all state and federal licenses and signed the Medicare Supplier Application so as to obtain a provider number. She worked at the office in a warehouse district daily from 8 am to 12 noon.
Her job was to prepare delivery orders based upon doctor’s prescriptions which she received from Soto or his wife, Damarris (who was not charged), and send them to the billing company so they could be submitted to Medicare for payment. She was present at two site inspections conducted by Medicare to determine if the DME company was in compliance with the 21 supplier standards. During those site inspections, she did not disclose Soto’s ownership interest in the company. After the second site inspection, CMS sent a Notice of Violation, indicating that the company was not in compliance with several supplier standards. One of the standards which they did not meet stated that the company did not have sufficient inventory or purchase records to support the amount of money they were billing Medicare.
The day after that Notice of Violation letter was received, Ramon Soto was captured on videotape arranging for the purchase of false invoices from a govenrment informant, Victor Suasnavas. Suasnavas owned a medical equipment supply company which wholesaled oxygen and medical equipment to DME companies. Suasnavas had been indicted for money laundering, and was cooperating with the government to obtain a lesser sentence. His office was outfitted by the FBI with hidden cameras and microphones. Suasnavas prepared the false invoices in exchange for 10% of the value of the invoices. A few days later, Soto was again captured on videotape paying Suasnavas $11,000 for the invoices. That same day, Denis Medical Services sent a reply letter to CMS, signed by Yeleiny Guerrero, which included the false invoices as proof of sufficient inventory to support the billing. Approximately 6 weeks later, in May 2007, Yeleiny Guerrero was captured on videotape when she came to Victor Suasnavas’ office with Damarris Soto. In that visit, Yeleiny was asked by Suasnavas to sign the false invoices “as if she had received the merchandise.”
Denis Medical Services ceased operations in June 2007. During the three month period from March to June 2007, Denis Medical received $192,000 in Medicare payments. Bank records demonstrated that Yeleiny Guerrero wrote checks payable to herself in the amount of $181,000, the majority of which were cashed. She deposited a total of $24,000 in checks from Denis Medical into her personal bank account.
bmw%20headshot%20%282%29.jpgUpon her arrest on August 31, 2007, Yeleiny Guerrero told the FBI that she met Ramon Soto when she was taking care of his child at a child care center where she worked. She and her husband became friendly with Soto and his wife, and they offered to set her up in a business. Soto would finance the company, and they would split the profits 70/30 in his favor. However, nothing could be in his name because he already owned other companies, and he would not be able to obtain a license or provider number. During the course of her employment from March 2006 to March 2007, she was paid $200 per week, until they began receiving checks from Medicare. From March 2007 until June 2007, Yeleiny Guerrero signed blank checks for Soto, which represented the bulk of the $181,000 which were made payable to her.
The defense was that Yeleiny was used by Soto, and had no knowledge of the Medicare fraud. After a three day trial, the jury deliberated for 7 hours, and returned a verdict
download file of Not Guilty on all counts. Yeleiny Guerrero was represented by attorney Barry Wax (pictured), President of the Miami Chapter of the Florida Association of Criminal Defense Lawyers. Mr. Wax is Of Counsel to the Law Offices of Robert David Malove.

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