Corporate Compliance

HIV clinics set up solely for Medicare fraud

Healthcare Auditing Weekly, March 24, 2009

On March 17, a federal jury convicted two physicians and two medical assistants in Miami in connection with a $5.3 million Medicare scheme, according to a Department of Justice (DOJ) press release

A jury found David Rothman, M.D., Keith Russel, M.D., Eda Marietta Milanes, and Jorge Luis Pacheco guilty on all counts, including conspiracy to commit healthcare fraud and multiple counts of healthcare fraud for submitting claims to Medicare for unnecessary medications.

According to the press release, the defendants worked as doctors and medical assistants at two Miami clinics that specialized in HIV treatment. One of the owners of the clinics testified that the clinics were established for the sole purpose of defrauding Medicare. Trial evidence showed that the clinics billed Medicare for $5.3 million and received $2.5 million during two years of operation.

Rothman faces a maximum of 50 years in prison, while the other three defendants each face a maximum 30-year sentence. Sentencing has been scheduled for June 26, 2009.

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