August 24, 11

NEWS / Miami-Area Medical Equipment Company Owners Sentenced to Prison for Medicare Fraud Scheme

WASHINGTON – The husband and wife owners and operators of a Miami-area medical equipment company were sentenced today to 70 months and 37 months in prison, respectively, for participating in a durable medical equipment (DME) health care fraud scheme, announced the Department of Justice, the FBI and the Department of Health and Human Services (HHS).



Obel Martinez, 39, and Damaris Gil, 30, previously pleaded guilty on May 24, 2010, before U.S. District Judge Donald M. Middlebrooks in Miami to one count of conspiracy to commit health care fraud. Martinez and Gil were owners and operators of OM Best Help Corporation, a company they admitted to incorporating for the purpose of defrauding the Medicare program.



In addition to their prison terms, Judge Middlebrooks sentenced Martinez and Gil each to three years of supervised release. Martinez and Gil also were ordered to pay $474,662 in restitution jointly and severally with each other.



According to plea documents, Martinez and Gil, through OM Best, submitted false and fraudulent claims to Medicare for DME and other medical items and services that were medically unnecessary and not prescribed by a doctor or licensed health care provider. Martinez and Gil used without authorization the Medicare billing identifiers of licensed medical doctors and represented to Medicare that the doctors had prescribed the DME and medical services in question, when they had not. Martinez and Gil knew that the Medicare beneficiaries, on whose behalf claims were submitted to Medicare by OM Best, never received the DME or services purportedly provided by OM Best.



According to court documents, Martinez and Gil submitted approximately $1.1 million in false claims to Medicare. Medicare paid $474,662 to OM Best based on these fraudulent claims.



Today’s sentences were announced by Assistant Attorney General Lanny A. Breuer of the Criminal Division; U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida; John V. Gillies, Special Agent-in-Charge of the FBI’s Miami field office; and Special Agent-in-Charge Christopher Dennis of the HHS Office of Inspector General (HHS-OIG), Office of Investigations Miami office.



This case was prosecuted by Trial Attorney Sarah M. Hall of the Criminal Division’s Fraud Section. The case was investigated by the FBI and HHS-OIG, and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida.



Since their inception in March 2007, Medicare Fraud Strike Force operations in nine locations have charged more than 1,000 defendants who collectively have falsely billed the Medicare program for more than $2.3 billion. In addition, HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.



To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov.

http://www.justice.gov/opa/pr/2011/August/11-crm-1073.html

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