Corporate Compliance

Miami residents open clinic in Detroit, defraud Medicare of $15M

Compliance Monitor, August 26, 2009

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On August 18, Jose and Arnaldo Rosario pleaded guilty to participating in a conspiracy to defraud the Medicare program of approximately $15.3 million, according to a Department of Justice (DOJ) release.
 
Jose Rosario, a Miami resident, admitted that he and a co-defendant opened Sacred Hope Medical Center Inc., in Detroit in September 2006. The owners claimed the facility specialized in injection and infusion treatments for Medicare patients. However, Jose Rosario admitted that Sacred Hope billed Medicare for treatments that were often never ordered or never administered. According to the DOJ, Jose Rosario admitted that Sacred Hope purchased a fraction of the amount of medications the facility billed Medicare. Jose Rosario allegedly paid co-conspirators to falsify claims to make them look legitimate.
 
Sacred Hope patients were not sent to the facility via physician order or referral, the DOJ said. Medicare beneficiaries were allegedly recruited and paid kickbacks for their participation in the scheme, which Arnaldo Rosario, Jose Rosario’s nephew, oversaw. The kickbacks were often cash payments, but some patients were also compensated in the form of narcotic prescriptions, according to the DOJ.
 
The two Rosarios also admitted to playing similar roles at two other clinic, Dearborn Medical Rehab Center (DMRC), a Dearborn, MI, infusion clinic, and Xpress Center, a Detroit-area infusion clinic.



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