Corporate Compliance

Miami residents charged with fraud for HIV infusion billing

Compliance Monitor, April 9, 2008

Seven Miami-area residents were indicted for allegedly paying kickbacks, submitting false claims, and conspiring to commit healthcare fraud, according to a Department of Justice (DOJ) press release.
 
Ana Alvarez, MD, 54, Mariela Rodriguez, 39, Aisa Perera, 42, Beatriz Delgado, 48, Angel Rodriguez, 40, Sandra Mateos, 43, and Carmen Gonzalez, 33, allegedly took part in an $11 million Medicare fraud scheme involving HIV infusion clinics.
 
The scheme centered on Saint Jude Rehab Center, Inc., which Mariela Rodriguez and Perera incorporated in June 2003, according to the DOJ. From June 2003 through November 2003, Saint Jude allegedly billed Medicare for approximately $11 million for HIV infusion services that were not actually provided and services that were not medically necessary. Medicare paid Saint Jude more than $8 million.
 
In June 2007, Orestes-Alvarez Jacinto, MD, a former physician at Saint Jude, pleaded guilty to conspiracy to commit healthcare fraud and was sentenced to 18 months in prison.

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