August 17, 09

NEWS / Miami Man Pleads Guilty to $123 Million Medicare Fraud Scheme

Jeffrey H. Sloman, Acting United States Attorney for the Southern District of Florida, Michael J. Folmar, Acting Special Agent in Charge, Federal Bureau of Investigation, Miami Field Office, and Christopher B. Dennis, Special Agent in Charge, U.S. Department of Health and Human Services, Office of Inspector General, Miami Regional Office, announced that defendant Reinaldo Guerra, of Miami, Florida, pled guilty today to one count of conspiracy to commit Medicare fraud and one count of Medicare fraud. Sentencing has been scheduled for November 13, 2009 at 11:00 a.m.

According to the joint factual statement filed in support of the plea, the fraud involved durable medical equipment (DME), which is equipment that can be used in the home on a repeated basis for a medical purpose. Where DME is prescribed or ordered by a physician, an authorized Medicare provider who supplies the equipment to a Medicare beneficiary may be eligible for reimbursement by Medicare.

Guerra owned and operated eleven (11) corporations that purported to supply DME to Medicare beneficiaries pursuant to physicians’ prescriptions or written orders, using straw or nominee owners to disguise his control over the companies. He submitted approximately $123 million in fraudulent claims to Medicare for DME that had not been prescribed or ordered by a physician nor delivered to a Medicare beneficiary. Based on those claims, Medicare paid the DME companies approximately $35 million.

Mr. Sloman commended the investigative efforts of the Federal Bureau of Investigation and the U.S. Department of Health and Human Services, Office of Inspector General. This case is being prosecuted by Assistant U.S. Attorney Marc Osborne

http://miami.fbi.gov/dojpressrel/pressrel09/mm081409.htm

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