Corporate Compliance

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

Compliance Monitor, April 1, 2009

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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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