Florida clinic owner and physicians charged with HIV/AIDS drug fraud
Healthcare Auditing Weekly, June 24, 2008
A Miami health clinic owner and five physicians were arrested on Thursday on charges of defrauding the Medicare and Medicaid programs of more than $15 million.
Owner Esther Romeu, and physicians Walter F. Proano, Manuel Barbeite, Alejandro Enrique Casuso, Carmen Lourdes Del Cueto, and Marco Tulio Molinares were arrested after a joint investigationby the Attorney General’s Medicaid Fraud Control Unit and the Federal Bureau of Investigation.
The group is alleged to have billed Medicare and Florida Medicaid programs $19,580 for
Intravenous Immune Globulin (IVIG) medications used to treat HIV/AIDS-related conditions and received $15.9 million from January 2003 to July 2006. These medications are usually administered on a monthly basis with careful monitoring of the patient’s blood count and detailed reports on the infusions, however, according to a Florida Department of Justice press release, the defendants are alleged to have billed as if they were administering these infusions to the patients three times a week and, in some cases for several years, a practice that would put a patient’s health in danger. The release also stated the medication was given without any of the necessary lab work or infusion reports.
Each defendant is being charged with various counts of conspiracy to commit health care fraud and substantive health care fraud violations, facing a maximum of 10 years in prison and a $250,000 fine on each count.
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