1 March 2005 – LAWFUEL – The Law News Network – Marcos Daniel Jiménez, United States Attorney for the Southern District of Florida;
Michael S. Clemens, Special Agent in Charge, Federal Bureau of Investigation; Linda
S. Little, Special Agent in Charge, Office of Inspector General, United States
Department of Health and Human Services; and Enrique Gutierrez, Postal Inspector in
Charge, United States Postal Inspection Service; announced today the return of a
thirty-three (33) count Indictment on February 25, 2005 charging five (5)
Miami-Dade County residents involved in a Medicare fraud and money laundering
operation and the arrests and subsequent initial appearances of the defendants.
Defendants, Isabel Guerra, Carlos Gonzalez, Isabel Canepa, and Pura Medina, are
charged with one (1) count of conspiracy to commit health care fraud and to pay
kickbacks, in violation of Title 18, United States Code, Section 371; nineteen (19)
counts of health care fraud, in violation of Title 18, United States Code, Sections
1347 and 2; one (1) count of conspiracy to commit money laundering, in violation
of Title 18, United States Code, Section 1956(h); and eleven (11) counts of money
laundering, in violation of Title 18, United States Code, Sections 1956(a)(1)(B)(i)
and 2. In addition, Guerra, Gonzalez, Canepa, and Isabel Santos are charged with
one (1) count of conspiracy to structure monetary transactions, in violation of
Title 18, United States Code, Section 371. The Indictment also seeks forfeiture of
more than $10 million, which Medicare paid out to the defendants during the
Indictment period. A civil injunction previously obtained by the United States
Attorney’s Office froze approximately $2.7 million in assets, including over
$600,000 in bank accounts. These preserved assets are the subject of the
forfeiture claim.
The Indictment alleges that Carlos Gonzalez, Isabel Guerra, and her mother Isabel
Santos, were whole or part owners of United Pharmacy Discount (“United”) and Ocean
Medical Supplies (“Ocean”). According to the Indictment, they, as well as Pura
Medina, who worked at United, and Isabel Canepa, who worked at Ocean, paid
kickbacks to patient recruiters so that they would provide the defendants and their
companies with Medicare beneficiaries to pose as patients, and to patients in order
to obtain from those Medicare beneficiaries their names and identification numbers,
along with prescriptions for Durable Medical Equipment (DME) and prescription drugs
relating to them.
Once they had patient information, the defendants completed Medicare required
orthotic measurement forms for DME without an orthotist or orthotic fitter ever
having measured a patient, forged the signatures of doctors on prescriptions for
DME and prescription drugs, and created entirely fraudulent patient files,
containing manufactured and forged documents. The defendants would share patients
between the defendants’ two (2) companies, billing the shared patients during
different Medicare billing periods, without the patients having been seen by any
doctor, orthotist, or fitter, and without having been prescribed any DME or
prescription drugs. Using the patients’ identification information and
prescriptions, the defendants then submitted claims to Medicare for reimbursement
for the cost of DME and prescription drugs, and received payments from Medicare.
The defendants, as alleged, then laundered some of the proceeds of the fraud by
paying someone who they believed was a newspaper owner for bogus advertising that
was never placed. The defendants would pay for the nonexistent advertising using a
check from either or both of the DME companies and the newspaper owner would pay
them back in laundered U.S. currency.
Isabel Guerra, Carlos Gonzalez, Isabel Canepa, and Pura Medina were arrested on
February 25, 2005, and with the exception of Isabel Guerra, made their initial
appearance in federal court in Miami, Florida, on that day. Isabel Guerra made her
initial appearance yesterday, February 28, 2005. Isabel Santos was arrested
yesterday and made her initial appearance in federal court in Miami yesterday
afternoon.
Mr. Jiménez commended the investigative efforts of the Federal Bureau of
Investigation, Office of Inspector General, United States Department of Health and
Human Services, and the United States Postal Inspection Service. The criminal case is being prosecuted by Assistant United States Attorney Luis Perez. The civil case
is being handled by Assistant United States Attorney Ana Maria Martinez.
