Miami physical therapist assistant convicted: Bilked insurer for millions

FLORIDA — A jury has convicted a physical therapist assistant in Miami of making over $2.6 million in fraudulent claims.

Last week, a Miami federal jury convicted Tania Cesar, 55, of Hialeah, of conspiracy to commit health care fraud and wire fraud and five counts of health care fraud after a week-long trial.

From May 2019 through February 2021, Ms Cesar worked as a physical therapist assistant at Elite Therapy Group Inc. (Elite) in Miami. During this period, Cesar reportedly signed over 1,500 physical therapy notes for physical therapy treatments that she never provided to patients.

Ms Cesar’s alleged false and fraudulent therapy notes led to over $2.6 million in claims billed to Blue Cross Blue Shield (BCBS).

Several co-conspirators testified, including the owners of Elite, describing the payment agreement between Elite and Cesar. According to testimony, Ms Cesar would come into the therapy clinic once or twice weekly to sign the therapy notes but never treated patients.

Some of Elite’s patients also testified, explaining that they had never received physical therapy treatment or met Cesar. Furthermore, Ms Cesar reportedly signed false and fraudulent therapy notes for treatments she purportedly performed on dates when airline and U.S. Customs and Border Protection (CBP) records confirmed that she was out of the country.

In addition, Cesar was said to be working full-time at another physical therapy clinic in Miami, where Ms Cesar logged hours that, when added up with the hours for purported physical therapy she signed for in fraudulent therapy notes from Elite, suggested that she was working more than 24 hours on multiple days.

Moreover, Cesar reportedly had the same financial relationship with another clinic, Zion Medical (Zion), before she began signing false and fraudulent therapy notes at Elite.

The owner of Zion testified that he and Ms Cesar had the same agreement that Cesar had with the owners of Elite and that Cesar signed false and fraudulent therapy notes for treatments she never performed. These false and fraudulent therapy notes were also billed to BCBS as part of the scheme.

Sentencing is set for May 6 before U.S. District Senior Judge Robert N. Scola Jr.

U.S. Attorney Markenzy Lapointe for the Southern District of Florida and Special Agent in Charge Jeffrey B. Veltri of the FBI, Miami Field Office, made the announcement.

FBI Miami investigated the case. Assistant U.S. Attorneys Joseph Egozi and Lindsey Lazopoulos Friedman are prosecuting it. Assistant U.S. Attorney Mitchell Hyman is handling asset forfeiture.