11/16/2008

News / Miami Clinic Owner Sentenced to 30 Months in Prison for $10.9 Million Medicare Fraud

WASHINGTON – Miami clinic owner Nayda Freire, 61, was sentenced today to 30 months in prison for defrauding the Medicare program in connection with a $10.9 million HIV infusion fraud scheme, Acting Assistant Attorney General Matthew Friedrich of the Criminal Division and U.S. Attorney R. Alexander Acosta of the Southern District of Florida announced.

In addition to the prison term, U.S. District Judge Adalberto Jordan also sentenced Freire to two years of supervised release following her release from prison and ordered her to pay $7,992,391 in restitution to the Medicare program. Freire pleaded guilty to one count of conspiracy to commit health care fraud in connection with her role as the owner of Global Med-Care Corp. Inc. (Global), a Miami-area HIV clinic that purported to provide HIV infusion services to Medicare beneficiaries.

In her plea, Freire acknowledged that between April 2003 and November 2003, she and others conspired to file $10.9 million in false claims to the Medicare program for HIV infusion services that were not provided and were not medically necessary. In addition, court documents explain how the patients at Global were paid cash kickbacks in return for agreeing to allow Global to bill Medicare for the unneeded services.

After payments from Medicare were made into the bank accounts of Global, Freire admitted that she and others transferred $6 million of the fraud proceeds to sham management, marketing and investment companies owned and operated by co-conspirators Carlos, Luis and Jose Benitez. Co-conspirators Carlos and Luis Benitez and Thomas McKenzie were charged separately with health care fraud and money laundering crimes in an indictment unsealed on June 11, 2008. According to the separate indictment, these co-conspirators allegedly provided the money and staff necessary to open Global, the Medicare patients who the clinic would bill to the Medicare program, and transportation for the HIV patients who visited the clinic. The indictment also alleges that Carlos and Luis Benitez were the true owners of Global. The Benitez brothers and McKenzie were charged with participating in the commission of approximately $109 million in HIV infusion fraud and money laundering through Global and 10 other HIV infusion clinics. On Sept. 18, 2008, McKenzie pleaded guilty to one count of conspiracy to commit health care fraud and one count of submitting false claims to the Medicare program, and also admitted his role in a $119 million HIV infusion fraud scheme. The Benitez brothers remain fugitives.

The Global case was prosecuted by Assistant Chief Hank Bond Walther and Trial Attorney N. Nathan Dimock of the Criminal Division’s Fraud Section, and investigated by the FBI and the Department of Health and Human Services’ Office of Inspector General. The case was brought as part of the Medicare Fraud Strike Force, supervised by Deputy Chief Kirk Ogrosky of the Criminal Division’s Fraud Section and U.S. Attorney Acosta of the Southern District of Florida. Since the inception of Strike Force operations in 2007, federal prosecutors have indicted 104 cases with 185 defendants in Los Angeles and Miami. Collectively, these defendants fraudulently billed the Medicare program for more than half a billion dollars.

http://www.usdoj.gov/opa/pr/2008/November/08-crm-1004.html

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