HIV clinics set up solely for Medicare fraud
Healthcare Auditing Weekly, March 24, 2009
On March 17, a federal jury convicted two physicians and two medical assistants in Miami in connection with a $5.3 million Medicare scheme, according to a Department of Justice (DOJ) press release.
A jury found David Rothman, M.D., Keith Russel, M.D., Eda Marietta Milanes, and Jorge Luis Pacheco guilty on all counts, including conspiracy to commit healthcare fraud and multiple counts of healthcare fraud for submitting claims to Medicare for unnecessary medications.
According to the press release, the defendants worked as doctors and medical assistants at two Miami clinics that specialized in HIV treatment. One of the owners of the clinics testified that the clinics were established for the sole purpose of defrauding Medicare. Trial evidence showed that the clinics billed Medicare for $5.3 million and received $2.5 million during two years of operation.
Rothman faces a maximum of 50 years in prison, while the other three defendants each face a maximum 30-year sentence. Sentencing has been scheduled for June 26, 2009.
Related Products
-
PPS Alert for Long-Term Care
Looking for a tool to make your job easier? PPS Alert for Long-Term Care, exclusively for the RN or MDS coordinator, is your...
-
The CMS Hospital Conditions of Participation
Save time navigating the CMS hospital conditions of participation with HCPro's hardcopy book of all the latest requirements...
-
The CMS Survey Coordinator's Handbook
There is no reason to struggle with CMS requirements. HCPro has teamed up with former contracted CMS surveyor Jeff Coleman...
-
CMS' Interpretive Guidelines for the Hospital Conditions of Participation
We'll help point you in the right direction! HCPro has taken the most recent version of the CoP Interpretive Guidelines...
-
Briefings on The Joint Commission
Briefings on The Joint Commission will help you with all of your accreditation and survey preparation needs. Every month...
Most Popular
- Articles
-
- Q/A: Billing telemetry daily monitoring
- Credentialing monthly: What is the role of the credentials committee in addressing unprofessional conduct?
- 2010 ICD-9 code updates now available online
- Master modifiers to ensure accurate reimbursement
- H1N1 hits Maine facility
- Radiologist indicted for fraudulently signing reports
- Don’t be scared into silence: Affiliation letter safeguards allow you to disclose more
- National Quality Forum creates standardized set of data for electronic health records
- New report reveals $47 billion in Medicare fraud
- Understand the H1N1 Flu and how to code it
- E-mailed
-
- Credentialing monthly: What is the role of the credentials committee in addressing unprofessional conduct?
- Q/A: Billing telemetry daily monitoring
- Radiologist indicted for fraudulently signing reports
- Revised MS.1.20 'huge improvement', out for comment again
- H1N1 hits Maine facility
- New report reveals $47 billion in Medicare fraud
- Briefings on Outpatient Rehab Reimbursement and Regulations, December 2009
- Hand hygiene rates improved through variety of reinforcement styles
- Press Ganey report: Patient satisfaction increasing across the country
- Residency Program Alert, December 2009
- Searched