Corporate Compliance

Detroit clinic owner faces 10 years in prison for Medicare fraud scheme

Compliance Monitor, November 4, 2009

On October 30, Daisy Martinez pled guilty in Detroit’s U.S. District Court to one count of conspiracy to commit healthcare fraud, according to a Department of Justice (DOJ) press release. Martinez, 50, opened a clinic purported to specialize in infusion and injection therapy, in March 2006, so she could submit false claims for Medicare reimbursement.
 
According to the DOJ, Martinez and co-conspirators opened Sacred Hope Medical Center Inc. and began to recruit various patients. Martinez and co-conspirators paid cash kickbacks to patients in exchange for signatures indicating they had received treatment from Sacred Hope. Martinez used these signatures to create false medical files to submit to Medicare. Martinez admitted to prescribing patients medicines based on what medications were likely to generate the highest Medicare reimbursement. 
 
Between 2006 and 2009, Martinez was also involved with two more infusion and injection clinics that participated in defrauding Medicare. The DOJ reports that in those three years, these clinics submitted approximately $15.3 million in false claims, which Medicare paid approximately $10.7 million. Martinez faces 10 years in prison and a $250,000 fine.

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