Corporate Compliance

Miami doctor and chemist altered blood samples to justify billing for HIV infusions

Compliance Monitor, April 1, 2009

Carmen Del Cueto, MD, and Alexis Dagnesses each pleaded guilty to one count of conspiracy to commit healthcare fraud in connection with a Medicare fraud scheme worth $10 million, according to a Department of Justice (DOJ) press release.
 
According to the DOJ, Cueto, co-owner and practicing physician at Midway Medical Center Inc., a Miami clinic, admitted he routinely billed Medicare for HIV infusion services that were medically unnecessary or never performed.
 
Midway billed Medicare for the infusions based on a diagnosis of thrombocytopenia, which is a condition where the patient has a low blood platelet count. According to the DOJ, Cueto and his co-conspirators enlisted Dagnesses and other chemists to alter blood samples to make normal blood samples appear to have low platelets.

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