Corporate Compliance

More Medicare fraud uncovered in South Florida

Compliance Monitor, June 4, 2008

South Florida remains a hotbed of Medicare fraud activity if the South Florida Medicare Fraud Strike Force’s efforts are any indication.
 
U.S. Attorney General Michael Mukasey praised the Strike Force for its success in bringing more than 120 cases against almost 200 defendants in a speech in Miami, Wednesday, May 28. Those cases accounted for almost 20% of the federal healthcare fraud prosecutions nationwide.
 
The Strike Force prosecutions show no signs of slowing. On Thursday, May 29, the agency filed four indictments against nine people for allegedly defrauding Medicare of a total of $56.2 million by submitting fraudulent bills for HIV infusion services, according to a Department of Justice (DOJ) press release.
 
One indictment claims Ronald Harris, MD, and Enrique Gonzalez submitted approximately $24.5 million in false claims to Medicare between August 2002 and March 2004. Gonzalez allegedly paid Medicare beneficiaries to sign documents stating they received treatment when the treatments were not medically necessary.
 
Harris allegedly ordered unnecessary tests, signed medical forms, and authorized treatments to make it appear that legitimate medical services were being provided to Medicare beneficiaries.
 
In a second indictment, Juan Carlos Castaneda, Dilcia Marinez, and Luis Frias are accused of submitting approximately $14 million in false claims to Medicare between May 2003 and January 2004. The three allegedly hired physicians to make it look like their HIV infusion clinic was providing legitimate services. They also allegedly paid Medicare beneficiaries to sign documents stating they received treatment when the treatments were not medically necessary
 
Jose Garcia  and Nayda Freire allegedly ran the same scheme as Castaneda, Marines, and Friad, and submitted approximately $10.9 million in false claims to Medicare between April 2003 and November 2003.
 
In a fourth indictment, Carlos Contreras, MD, and Ramon Pichardo, MD, are accused of submitting $6.8 million in false claims to Medicare between November 2002 and April 2004. The physicians ordered unnecessary tests and paid Medicare beneficiaries to sign documents stating they received treatment when the treatments were not medically necessary, according to the DOJ.

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