Corporate Compliance

Clinic owner sent to prison for largest individual case of Medicare fraud

Compliance Monitor, April 9, 2008

A Miami woman will spend 10 years in prison for her role in the largest known individual case of fraud in the history of Medicare, according to a Department of Justice press release.
 
Between October 2002 and April 2006, Rita Campos Ramirez, 60, owned and operated R&I Medical Billing Inc., a medical billing company that specialized in submitting bills to the Medicare program on behalf of HIV infusion clinics. On August 28, 2007, pleaded guilty to one count of conspiracy to commit healthcare fraud and one count of submitting false claims to Medicare. She admitted to knowingly submitting fraudulent medical bills to Medicare. Medicare paid approximately $105 million for the fraudulent bills, with Campos personally receiving $5 million.
 
In addition to her prison term, Campos will:
  • Be placed on three years of supervised release following her release from prison
  • Forfeit $207,000, her three homes and an automobile >
  • Pay $105 million in restitution to the U.S. Department of Health and Human Services

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