A federal judge in Miami sentenced Tania Cesar, a physical therapist assistant (PTA), to 39 months in prison and three years of supervised release after a jury found her guilty of conspiracy to commit healthcare fraud and wire fraud, and five counts of healthcare fraud. According to evidence presented during a weeklong trial last February, over a two-year period at Elite Therapy Clinic, Cesar signed over 1,500 physical therapy notes for treatments and services that she never provided to patients. Several patients testified at trial, many of whom were paid cash in exchange for visiting Elite Therapy, that they did not recognize Cesar, despite their medical records reflecting months of treatment that Cesar purportedly provided. Elite Therapy coworkers testified that Cesar only visited Elite once or twice per week for a few hours to fill out fabricated progress notes. The fraudulent treatment notes led to over $2.6 million in claims billed to Blue Cross Blue Shield (BCBS) and other insurance companies.
Trial testimony showed that the year before Cesar started committing fraud at Elite Therapy, Cesar fabricated patient therapy notes at Zion Medical Group Inc., a clinic whose owner was separately convicted for conspiracy to commit healthcare fraud and wire fraud. The sentencing record showed that the year before the Elite Therapy fraud, Cesar was fired from another medical clinic for billing for therapy that she never provided. At sentencing, US District Court Senior Judge Robert N. Scola, Jr. found that Cesar employed sophisticated means at Elite Therapy to execute and conceal her fraud, and that she abused her special skills as a PTA. Judge Scola ordered that upon Cesar’s release from prison, she cannot work in the healthcare field while on supervised release, and upon request from the appropriate regulatory agency Cesar must relinquish her PTA license. Cesar was also ordered to pay $939,334.05 in restitution.
