08/28/2008

News / MIAMI PHYSICIAN AND HIV CLINIC ADMINISTRATOR PLEAD GUILTY FOR THEIR ROLES IN A $37 MILLION MEDICARE FRAUD SCHEME

MIAMI PHYSICIAN AND HIV CLINIC ADMINISTRATOR PLEAD GUILTY
FOR THEIR ROLES IN A $37 MILLION MEDICARE FRAUD SCHEME

Doctor Wrote Prescriptions for Unnecessary HIV Infusion Treatments at Clinic;
Administrator Ran Related HIV Infusion Clinic

WASHINGTON - Miami physician Ronald Harris, M.D., and Miami resident Mariela Rodriguez each pleaded guilty today to defrauding the Medicare program in connection with a $37 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.

Harris pleaded guilty to conspiracy to commit healthcare fraud and three counts of submitting false claims to the Medicare program before U.S. District Judge Cecilia M. Altonaga. In his plea, Harris admitted that he wrote false prescriptions for HIV infusion treatments while serving as the medical director for two medical clinics, Physicians Med-Care and Physicians Health. Both clinics purported to provide HIV infusion services to Medicare beneficiaries. Harris admitted that beginning in August 2002 and continuing through March 2004, he conspired with others to defraud the United States, to cause the submission of false claims to the Medicare program, to pay health care kickbacks and to commit health care fraud. Harris also admitted to submitting false claims.

According to information contained in plea documents, Harris admitted that between August 2002 and March 2004 he served as the medical director of Physicians Med-Care and Physicians Health, two Miami HIV infusion clinics that were owned and controlled by Carlos and Luis Benitez, and that were operated for the purpose of committing Medicare fraud. Prior to August 2002, Harris had no prior experience with infusion therapy for HIV patients. During his employment with Physicians Med-Care and Physicians Health, Harris admitted he approved approximately $26.2 million worth of fraudulent medical bills, signed documents containing false information about treatments purportedly provided to HIV patients and approved medically unnecessary treatments. According to information in the plea documents, the Medicare program paid approximately $17.5 million in fraudulent bills as a result of Harris' conduct.

Rodriguez pleaded guilty before U.S. District Judge Federico Moreno to conspiracy to commit health care fraud and one count of making false declarations to a federal grand jury. In her plea, Rodriguez admitted that she administered an HIV infusion clinic named Saint Jude Rehab Center, a Miami HIV infusion clinic that was owned and controlled by Carlos and Luis Benitez, and that was operated for the purpose of committing Medicare fraud. Similar to Physicians Med-Care and Physicians Health, Saint Jude purported to provide HIV infusion services to Medicare beneficiaries.

Rodriguez admitted that she served as an administrator of Saint Jude between June 2003 and November 2003, during which time she submitted false claims to the Medicare program for HIV infusion treatments. Rodriguez further admitted that beginning in June 2003 and continuing through November 2003, she conspired with others to defraud the United States, to cause the submission of false claims to the Medicare program, to pay health care kickbacks and to commit health care fraud. Rodriguez also admitted to making false statements in her testimony before a federal grand jury. Between June 2003 and November 2003, Saint Jude submitted approximately $11.3 million worth of fraudulent bills to the Medicare program for HIV infusion services that were never provided and services that were medically unnecessary. As a result of this conduct, the Medicare program paid approximately $8.2 million in fraudulent bills. Sentencing for both Rodriguez and Harris has been scheduled for Nov. 4, 2008.
In a related case, Carlos and Luis Benitez, as well as their brother Jose Benitez, were indicted on June 11, 2008, for their role in a $110 million HIV infusion fraud and money laundering scheme. The indictment alleges that Carlos, Luis and Jose Benitez were the masterminds of a massive HIV infusion fraud operation throughout south Florida involving at least 11 clinics and that they laundered the proceeds of their crimes. Also according the indictment, Carlos and Luis Benitez were the true owners of Physicians Med-Care, Physicians Health and Saint Jude. All three Benitez brothers remain fugitives.

The cases were prosecuted by Hank Bond Walther, John K. Neal and 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 cases were 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. Strike Force prosecutors have indicted 82 cases involving 142 defendants since Strike Force operations began in March 2007. Collectively, these defendants committed more than $492 million in Medicare fraud.

Source: http://miami.fbi.gov/dojpressrel/pressrel08/mm20080826.htm

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