US Attorney – Doctors and Medical Assistants Plead Guilty In $10 Million Medicare Fraud

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Four Miami-area residents pleaded guilty today in connection with a $10 million Medicare fraud scheme involving HIV infusion clinics, Acting Assistant Attorney General Rita M. Glavin of the Criminal Division and U.S. Attorney R. Alexander Acosta of the Southern District of Florida announced today.

Dr. Roberto Rodriguez, 54; Dr. Carlos Garrido, 69; Gonzalo Nodarse, 38; and Alexis Carrazana, 41; all pleaded guilty before U.S. District Judge Paul C. Huck to one count of conspiracy to commit health care fraud. All four defendants admitted to working at Midway Medical Center Inc. (Midway), a Miami clinic that purported to specialize in the treatment of HIV patients.

According to the plea documents, Rodriguez was a co-owner of and practicing physician at Midway. Rodriguez admitted that he and his co-conspirators routinely billed the Medicare program for services that were medically unnecessary and, in many instances, never provided. Rodriguez admitted to purchasing only a small fraction of the medication that was purportedly being administered to Midway’s patients.

Most of the services provided to patients at Midway were billed to the Medicare program as treatments for a diagnosis of thrombocytopenia, a disorder involving a low count of platelets in the blood. According to the plea documents, none of Midway’s patients actually had low blood platelet counts. Rodriguez admitted that to make it appear that the patients actually had low platelet levels, he and his co-conspirators used chemists to manipulate the blood samples drawn from Midway’s patients before the blood was sent to a laboratory for analysis. In his plea, Rodriguez admitted to ordering that patients at Midway receive medications to treat thrombocytopenia despite knowing that the laboratory results had been falsified and the patients did not actually have that condition.

Midway was not the only clinic where Rodriguez purported to treat HIV patients with injection and infusion therapies. In his plea, Rodriguez admitted that he was listed as a medical director and practicing physician for five other Miami-area HIV infusion clinics between approximately October 2003 and February 2005, where he engaged in similar misconduct. Specifically, Rodriguez admitted he and his co-conspirators billed the Medicare program for HIV injection and infusion services that Rodriguez knew were medically unnecessary and, in some instances, never actually provided. Rodriguez admitted to causing more than $20 million in false claims to be submitted to the Medicare program at all of his clinics, including Midway.

Like Rodriguez, Garrido was a part-owner and practicing physician at Midway. In his plea, Garrido admitted that he and his co-conspirators routinely billed the Medicare program for services that were medically unnecessary and, in many instances, never provided. Garrido admitted to purchasing only a small fraction of the medication that was purportedly being administered to Midway’s patients. Garrido ordered that patients be treated with medications he knew they did not need and that, in many instances, he knew the clinic did not have available to provide to the patients. Garrido admitted to working at Midway for approximately eight months before the clinic closed, during which time he admitted to submitting more than $1 million in fraudulent claims to the Medicare program.

Nodarse and Carrazana worked at Midway as medical assistants. In their pleas, the two assistants admitted to making false entries in medical records indicating that they had provided medications on particular dates and in particular dosages to patients, when, in fact, they had not provided medications. The medical assistants also admitted to being fully aware that blood samples drawn from Midway’s patients were tainted to make it appear that the patients had conditions they did not have. Both assistants admitted to administering medications to patients that they knew the patients did not need. Nodarse, who worked at Midway throughout its existence, admitted to conspiring to submit more than $10 million in false and fraudulent claims for HIV infusion services allegedly provided at the clinic.

The case is being prosecuted by Trial Attorney John K. Neal of the Criminal Division’s Fraud Section. The FBI and the Department of Health and Human Services, Office of Inspector General, conducted the investigation. The case was brought as part of the Medicare Fraud Strike Force (MFSF), supervised by Deputy Chief Kirk Ogrosky of the Criminal Division’s Fraud Section and U.S. Attorney Acosta of the Southern District of Florida. Since the inception of MFSF operations, federal prosecutors have indicted 106 cases with 192 defendants in both Los Angeles and Miami. Collectively, these defendants fraudulently billed the Medicare program for more than half a billion dollars.
A copy of this press release may be found on the website of the United States Attorney’s Office for the Southern District of Florida at www.usdoj.gov/usao/fls. Related court documents and information may be found on the website of the District Court for the Southern District of Florida at www.flsd.uscourts.gov or on http://pacer.flsd.uscourts.gov.


Wolf Block partners met at 1p.m. today to discuss the fate of the firm and have issued a statement that they voted to commence an “orderly unwinding of the firm’s business.”

Wolfblock

Wolf Block partners met at 1p.m. today to discuss the fate of the firm and have issued a statement that they voted to commence an “orderly unwinding of the firm’s business.”

“Wolf Block will remain in the practice of law for several months to protect the interests of its clients, employees and creditors,” the firm said in a statement. “The decision to unwind was reached in view of a confluence of unfavorable factors: the economic recession, especially in the firm’s core real estate practice; the constriction of credit occasioned by the ongoing banking crisis; and the intended and anticipated departure of significant partners and practices.”

The partners determined the continued attempts to finance the firm’s operations would create more harm than good for clients and employees, the statement said. Wolf Block hired consulting firm Hildebrandt and Leslie D. Corwin of Greenberg Traurig to work with firm leadership to relocate as many people as possible, while liquidating the firm’s obligations.

“We are deeply saddened by the decision to unwind,” said firm Chairman Mark L. Alderman. “But we intend to conduct ourselves during this difficult time with the pride, focus, humility and determination that have characterized WolfBlock lawyers for more than a century. This result is ironic given that many of our practices and offices continue to perform at a high level despite our difficulties.”

Several sources have said members of the executive committee met Saturday to discuss a possible dissolution of the firm. The matter was said to be set for a full partnership vote at 1p.m. Monday. A decision to dissolve the firm would have needed to be approved by at least 75 percent of the partnership, one source said.
There is no indication that the firm is in dire financial straits, though it saw some significant declines in several key financial indicators in 2008 and was said to be seeking extensions of its line of credit. Sources have said work and receivables are still there and the firm isn’t said to be considering any sort of bankruptcy filing in the immediate future — a situation that has befallen a few other firms across the country in recent months.

Wolf Block saw its gross revenue fall 7.8 percent from $173 million in 2007 to $159.5 million in 2008. The firm’s equity partner tier fell by 34.8 percent from 86 equity partners to 56 and, conversely, the non-equity tier rose by 36.6 percent from 71 non-equity partners to 97 in 2008. The overall headcount fell about 4.6 percent from 304 attorneys to 290 in 2008.

Revenue per lawyer (RPL) dropped by about 3.3 percent, falling from $568,000 in 2007 to $549,000 in 2008. The profits per equity partner (PPP) and average compensation for all partners took more significant hits. The PPP fell 18.5 percent from $502,000 to $409,000 and the average compensation for partners dropped by 19.7 percent from $400,000 to $321,000 in 2008.

Sources have said that Alderman has potentially worked out a deal to join Cozen O’Connor, a former merger candidate for Wolf Block, and other attorneys may make the move with him.

One source familiar with the firm’s financial situation said Wolf Block sought in late 2008 an extension of its line of credit with Wachovia. After some back and forth, it was eventually decided that the line of credit would have to be personally guaranteed by each partner. That didn’t go over well and a number of partners announced they would leave before signing such a deal, the source said.

Ultimately, Wachovia — now owned by Wells Fargo — extended the line until March 31 without mandating the partners personally guarantee it. But by that time, the source said, a large number of attorneys, including all of the New York office, said they would be moving to Cozen O’Connor. Some put the number close to 100 attorneys while others said it was still fluid and was probably lower.
Wachovia could only confirm that Wolf Block was a client.

Thomas A. “Tad” Decker, president of Cozen O’Connor said the firm has a policy not to confirm or deny any discussions it has with laterals or merger partners.

“It’s not a happy day when you see a firm with the reputation of Wolf Block going out of business, if that’s true,” Decker said earlier today.

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