Law Enforcement Seizes Range Rover and Over $4 Million in Health Care Fraud Proceeds from Miami Couple Charged with Heal

Unknown 2019 Behavioral Health
OIG Healthcare Fraud
Penalty
$20 million

Outcome

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Details

Law Enforcement Seizes Range Rover and Over $4 Million in Health Care Fraud Proceeds from Miami Couple Charged with Heal — $20,000,000 Settlement

Outcome: Official websites use .gov A .gov website belongs to an official government organization in the United States.

Official websites use .gov A .gov website belongs to an official government organization in the United States.

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MIAMI – Magaly Travieso, 53, of Miami, Fla., was charged with conspiracy to commit health care fraud, and Yudorki Ramirez, 52, of Miami, Fla., was charged with conspiracy to commit money laundering. According to the allegations, Travieso was an advanced practitioner registered nurse and the owner of ProMed Healthcare, L.L.C., a medical clinic that purportedly provided back and shoulder braces, physical therapy, psychosocial rehabilitation, and other mental health therapy services to beneficiaries with commercial insurance, Medicare, and Medicare Advantage Plans, and to Medicaid recipients. From approximately March 2019 through at least January 2023, Travieso allegedly conspired with others to submit over $20 million in fraudulent claims for reimbursement, of which ProMed received over $10 million.

HHS Office of Inspector General

How Crucible Prevents This

Crucible's compliance monitoring controls for Behavioral Health / SUD Treatment would have detected the patterns underlying this violation through automated screening, documentation enforcement, and real-time alert escalation.

Source: Law Enforcement Seizes Range Rover and Over $4 Million in Health Care Fraud Proceeds from Miami Couple Charged with Health Care Fraud and Money Laundering Conspiracies

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