Neither their age nor their decades of work in health care spared two local physicians and a nurse from lengthy federal prison terms Wednesday for their roles in what prosecutors describe as a $50 million Medicare fraud scheme, although a judge handed each of them shorter terms than federal guidelines suggested.

U.S. District Judge Sarah Vance gave a five-year sentence to Dr. Roy Berkowitz, 69, of Slidell and a 6 1/2-year sentence to Dr. Barbara Smith, 67, of Metairie. Vance sentenced New Orleans nurse Beverley Breaux, 67, to more than four years.

All three, along with office manager Jo Ann Murthill, 58, of New Orleans, who was sentenced last month to four years in prison, were convicted in a May trial of defrauding the government by filing false claims on thousands of Medicare recipients who they certified were homebound and needed health services and equipment.

They were among 13 people indicted beginning two years ago in a fraud case centered on companies owned and operated by Mark Morad, of Slidell, who pleaded guilty a year ago and awaits sentencing.

Federal prosecutors said the scheme ran through multiple companies over the course of a decade, with thousands of false Medicare claims submitted and kickbacks paid to people who recruited the phony patients.

Vance ordered Berkowitz, Smith and Breaux each to pay millions of dollars in restitution to the government.

She ordered Berkowitz to pay $5 million.

“I very deeply regret the part that I played in this matter,” the doctor told the judge. “I really only intended to get medical care to medically disenfranchised people. I request mercy.”

Federal sentencing guidelines called for Berkowitz to serve eight to 10 years in prison. Vance cited the nonviolent nature of the crimes and Berkowitz’s health problems in her decision to impose a lighter sentence.

Smith, who voluntarily surrendered her medical license, more readily admitted that she was enticed by the money. Vance tagged her with $9.5 million in restitution payments.

“The only excuse I can offer is I was drinking very heavily. My moral compass was extremely impaired,” Smith said, adding that she’s been sober for three years.

Prosecutors said Smith submitted phony claims for thousands of patients who didn’t need home health care between 2009 and 2012.

Breaux was accused of shuttling nearly 500 Medicare patients to the fraudulent operation. Vance ordered her to pay $2 million in restitution, along with her 50 months in prison.

Appearing stunned, Breaux said she worked there for only 10 months.

“When I went to the company I went as a nurse, and that’s what I worked on, caring for the sick and elderly,” she said. “As far as what they were doing above me, I knew nothing about it.”

Vance noted Breaux’s short-time status in reducing her sentence from federal guidelines calling for her to serve from 6 1/2 to eight years in prison. But the judge said Breaux’s “absence of any acceptance and remorse in this case ... is somewhat disturbing.”

The nine other defendants in the case all have pleaded guilty.

The case was investigated by the FBI, the U.S. Department of Health and Human Services and the Louisiana Attorney General’s Office. The federal prosecution was launched by the Medicare Fraud Strike Force and U.S. Attorney Kenneth Polite’s office.

New Orleans is one of nine cities across the country where the strike force operates, according to the U.S. Department of Justice.

Follow John Simerman on Twitter, @johnsimerman.