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topicnews · September 6, 2024

Macomb County couple convicted of Medicare fraud and tax evasion

Macomb County couple convicted of Medicare fraud and tax evasion

A Macomb County couple who owned a home health care business was sentenced to prison this week for Medicare fraud and tax evasion, officials said.

Noli and Isabel Tcruz, both 68 and of Washington Township, were sentenced Wednesday in U.S. District Court in Detroit, U.S. Attorney Dawn Ison said in a statement. Ison said a federal judge sentenced Noli Tcruz to six years in prison and his wife to 38 months.

Her conviction came months after two doctors pleaded guilty to accepting kickbacks and bribes from the Tcruzes, she said.

“My office will diligently investigate and prosecute all types of fraud driven by greed,” the U.S. Attorney said. “Noli and Isabel Tcruz’s fraud harmed taxpayers and the government programs funded with our tax dollars, including Medicare and COVID-19 programs. Health care professionals and providers have both the opportunity and the duty to lawfully help people, but we will not hesitate to pursue individuals like these defendants who violate those duties to enrich themselves.”

The Tcruzes’ lawyers were not immediately available for comment on Friday.

In July 2020, charges were filed against the couple. Both Tcruzes were charged with tax evasion and several counts of health care fraud. The charges came after an investigation by the IRS Criminal Investigation Division and the Office of the Inspector General of the Department of Health and Human Services.

According to federal prosecutors, the couple owned and operated several home care agencies in Roseville, including Maxicare Home Health Agency Inc. and Faith Home Care Services LLC, between May 2011 and January 2018. The couple also owned and operated home care agencies in Arizona and Nevada, officials said.

As part of their scheme, the Tcruzes paid kickbacks and bribes to doctors to refer Medicare patients to their companies. The doctors also gave the couple patient information, which they used to submit fraudulent Medicare claims for home care services. According to investigators, the couple earned about $5 million from the conspiracy.

In addition, the couple refused to pay their income taxes and taxes on their businesses, prosecutors said. Authorities alleged that the two intentionally avoided paying approximately $602,154.91 in taxes (excluding interest and penalties) that had been assessed against them between 2006 and 2009.

Officials say the couple used their business accounts to pay more than $1.6 million in personal expenses. They also diverted money from their companies to other people, who then used the money to pay for the couple’s personal expenses. The expenses included a $675,000 home in Michigan and a $925,000 home in Nevada.

Investigators also said that after the Tcruzes’ last home health care business closed in February 2020, Noli Tcruz defrauded a federal COVID-19 program by using a family member’s identity and business to steal more than $250,000 in pandemic relief funds from the Small Business Administration and the Department of Health.

Ison said two doctors charged along with the Tcruzes, Terry Baul and David Calderone, pleaded guilty to accepting kickbacks and bribes to refer patients to the couple’s companies.

As part of a settlement, the two doctors were required to pay more than $3 million in damages and loss compensation, she said. In addition, the two were excluded from Medicare and other government health programs.

“Today’s sentencing of Noli and Isabel Tcruz demonstrates that the Internal Revenue Service’s Criminal Investigation Division and the U.S. Attorney’s Office will continue to aggressively pursue those who use fraudulent schemes to steal from America’s hard-working taxpayers,” said Charles Miller, special agent in charge of the IRS’s Detroit Field Office of Criminal Investigation. “Not only was money intended for Americans’ health care blatantly stolen, but U.S. citizens were also robbed when taxes were not paid on the couple’s income.”

In June, US Attorney General Merrick Garland announced that prosecutors had charged 193 people in various fraud cases, alleging that the federal government had been defrauded of nearly $3 billion through false insurance claims.

Officials said seven people with ties to Michigan were among them and were charged under federal anti-healthcare fraud measures.

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@CharlesERamirez