Corporate Compliance

Miami doctor convicted in $23 million Medicare fraud scheme

Compliance Monitor, April 20, 2011

A jury convicted Miami physician Rene De Los Rios of five felony counts for his role in a $23 million HIV injection and infusion Medicare fraud scheme, according to a Department of Justice (DOJ) press release.

According to the DOJ, Damaris Oliva, owner and operator of Metro Med of Hialeah Corp, hired De Los Rios to order unnecessary tests, sign medical analysis and diagnosis forms, and authorize treatments to make it appear that Metro Med provided legitimate medical services to Medicare beneficiaries. De Los Rios also diagnosed almost all of the patients at Metro Med with the same rare blood disorders, which the patients did not have, to ensure maximum reimbursement from Medicare.   

According to the DOJ, Oliva paid the De Los Rios $3,000 per week for his involvement in the scheme.

De Los Rios faces a maximum of 10 years in prison and a $250,000 for the conspiracy charge. He could receive up to an addition five years for each false claims count.

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