Corporate Compliance

Two Miami case managers arrested for Medicaid fraud

Compliance Monitor, August 6, 2008

A pair of case managers, formerly employed by the Project AIDS Care Waiver program, was arrested on July 30, for allegedly defrauding Florida’s Medicaid program for more than $139,000, according to the South Florida Business Journal,.
 
Negia Peguero and Olvin Rosado allegedly referred Medicaid recipients to a Medicaid provider for medical supplies the recipients did not need. Alfredo Distribution, the provider, would then bill Medicaid for reimbursement and give a portion of the money to Peguero and Rosado.
 
Peguero and Rosado are both charged with one count of organized fraud and one count of grand theft. The owners of Alfredo Distribution—Alfredo Guedes and Mayra Guzman—were arrested in November and charged for their participation in the alleged scheme. That case is pending.
 
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