Corporate Compliance

Miami doctor sentenced to more than 19 years in prison for Medicare fraud scheme

Compliance Monitor, June 29, 2011

Rene De Los Rios, 72, was sentenced to more than 19 years behind bars for his part in a $23 million HIV injection and infusion Medicare fraud scheme, according to a Department of Justice (DOJ) press release.

A Miami jury convicted De Los Rios of one count of conspiracy to commit healthcare fraud and four counts of submission of false claims April 14. The judge also ordered that De Los Rios and his co-defendants to pay a minimum of $11.7 million in restitution.

While working for three separate Miami-area clinics, De Los Rios signed medical documents authorizing tests and treatments that were medically unnecessary or never provided. De Los Rios signed medical charts, often without seeing the patient, indicating that treatments were medically necessary, when he knew they were not. 

The jury found De Los Rios responsible for fraudulently billing Medicare for $46 million. According to the DOJ, De Los Rios made more than $587,000 in profits from the fraud scheme.

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