Corporate Compliance

More Medicare fraud convictions in Miami

Compliance Monitor, May 7, 2008

Score two more convictions for the Florida Medicare Fraud Strike Force.
 
Miami pharmacist Gustavo Smith, 43, and Miami dermatologist Ana Caos, 62, are the latest convicted of healthcare fraud as a result of investigations by the Florida Medicare Fraud Strike force, according to a Department of Justice (DOJ) press release.
 
For his role in a $3 million Medicare fraud scheme, Smith was convicted of conspiracy to:
  • Defraud the U.S. government
  • Commit healthcare fraud
  • Submit false claims to the Medicare program;
  • Commit money laundering
 
Smith was also convicted of:
  • Seven counts of healthcare fraud
  • Seven counts of submitting false claims to the Medicare program
  • One count of money laundering
 
Smith’s Medstar pharmacy billed Medicare for durable medical equipment that patients did not need and did not receive, according to the DOJ. As part of the scheme, Smith billed the Medicare program approximately $3 million for negative pressure wound pumps, wound care supplies, and pharmaceuticals in one year.
 
In a separate case, Caos was convicted of conspiracy to defraud the U.S. government, to cause the submission of false claims to Medicare, and to solicit and receive kickbacks; and conspiracy to commit healthcare fraud, according to a DOJ press release. Caos was originally convicted on March 7, but the court ordered a retrial based on issues that arose during Caos’ prior testimony.
 
Caos wrote prescriptions for medications patients did not want or need, solely for the purpose of billing Medicare for the medication, according to the DOJ. She also falsely diagnosed patients with chronic obstructive pulmonary disease and prescribed unnecessary compounded aerosol medications that the patients threw away.

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