Pediatric care administrator allegedly bilks Medicaid out of $400,000

FLORIDA — The administrator of a Central Florida pediatric extended care business has been arrested in connection with alleged Medicaid fraud.

Attorney General Ashley Moody’s Medicaid Fraud Control Unit (MFCU) announced it has charged Carlos Cabrera, 58, with Medicaid provider fraud. The MFCU alleges that Cabrera stole hundreds of thousands of dollars from a state taxpayer-funded program.

Cabrera reportedly ran Angels on Earth, a prescribed pediatric extended care business with locations in Orlando, Melbourne, Haines City, and Lakeland. He is accused of submitting fraudulent claims for services that should have been provided to children with medically complex conditions, “bilking Florida Medicaid out of more than $400,000,” the MFCU said.

“This defendant used vulnerable children and their families for his own financial gain by overbilling and stealing from a taxpayer-funded program,” said Moody.

“My Medicaid Fraud Control Unit uncovered this devious scheme and will now ensure this defendant faces justice.”

According to an investigation by the MFCU, Cabrera worked as the administrator for Angels on Earth PPEC. PPEC businesses provide continual care for children with medically complex conditions in a nonresidential setting. Cabrera, the person reportedly responsible for all Medicaid PPEC billing, billed a nearly 100% attendance rate to get the maximum payment per patient despite knowing that not everyone attended every day, the MFCU said.

According to the MFCU, an analysis of Medicaid recipient data and the Angels on Earth Daily Census Reports showed that services were not rendered for up to 34% of the claims submitted for reimbursement. The overall pattern of billing and submitting claims to Medicaid, despite children being absent, demonstrates an intent to maximize billing without regard for accuracy, the MFCU said.

Cabrera faces one count of Medicaid provider fraud, a first-degree felony. The case will be prosecuted by Attorney General Moody’s Office of Statewide Prosecution.