Corporate Compliance

Ten arrested for Medicare fraud in Puerto Rico

Compliance Monitor, January 25, 2012

A federal grand jury in the District of Puerto Rico indicted 10 individuals on 39 counts of conspiracy to commit healthcare fraud for nearly $2 million, according to a January 19 OIG press release. Among those indicted were Gilberto Gómez, president of Monte Mar Health Corporation, PROMEDS Medical Inc., and Quality Care Medical Supply, and his wife Yolanda García-Rodríguez, president of PROMEDS, secretary/treasurer of Monte Mar, and official at Quality.

Court documents indicate that between November 2008 and May 2010, Monte Mar Health Corporation submitted approximately 1,518 fraudulent claims for durable medical equipment (DME) resulting in a total of $1,440,597.65 in Medicare payments.

Gómez purchased PROMEDS in March 2010 and submitted approximately 359 in fraudulent claims to Medicare for DME which resulted in payments from Medicare totaling $335,493.12.

Lastly, Gomez purchased Quality and from October 2010 to May 2011 submitted false claims to Medicare and received $180, 657.77 in payments. Ultimately, Medicare paid a total of $1,956,750.54 to the three companies.

The defendants could face up to 10 years in prison for the healthcare fraud and a fine of up to $250,000.

Read more on the OIG website.

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