Lawfuel.com – News Network – Law Jobs – R. Alexander Acosta, United States Attorney for the Southern District of Florida, Alice Fisher, Assistant Attorney General for the Criminal Division, Melody Jackson, Special Agent in Charge, U.S. Department of Health and Human Services, Office of the Inspector General, Jonathan I. Solomon, Special Agent in Charge, Federal Bureau of Investigation announce today that a jury convicted Ricardo R. Aguera a/k/a Pichi, the owner of three Miami durable medical equipment (DME) companies, of defrauding the Medicare Program of millions of dollars. Ricardo Aguera was remanded into custody to await sentencing scheduled for June 12, 2007 before the United States District Judge. Four other defendants, Ivan Aguera, Robert Berenguer, Aristides Berenguer and Carlos Berenguer, entered guilty pleas to all counts in the indictment without plea agreements prior to trial. All five defendants are related and run health care companies that were involved in the fraud scheme.
Co-conspirator pharmacy owners, Henry Gonzalez and Alfonso Rodriguez, billed the Medicare program for over 20 million dollars and reached agreements with DME owners, including defendants Ricardo R. Aguera, Ivan Aguera, Robert Berenguer, Aristides Berenguer and Carlos Berenguer, to kickback half of the money paid by Medicare in exchange for the DME owners bringing patients to the pharmacies. Testimony at trial revealed that the DME owners paid the patients to get access to their Medicare information so they could buy phony prescriptions from corrupt doctors to provide to the pharmacies.
The heart of the conspiracy centered around three Miami pharmacies, Lily’s Pharmacy, Unimed Pharmacy and Prestige Pharmacy, that illegally manufactured aerosol medications including Albuterol, Metaproterenol, and Ipatropium Bromide. These aerosol drugs are introduced into the lung through a piece of durable medical equipment known as a nebulizer.
Medicare pays for such aerosol medication through the Part B program as it is taken through a nebulizer. Knowing this Medicare system rule, the pharmacy owners exploited the program by manufacturing the unnecessary, non-FDA approved medicine through a process known as “compounding.” Evidence at trial established that at Lily’s pharmacy, one of the men making the medicine was trained to repair air conditioners and was not a licensed pharmacist.
The fraud scheme further relied on (1) paid patients who provided their Medicare cards and signed delivery receipts for medicine which they did not need and which they ultimately discarded, (2) doctors who signed fraudulent prescriptions which listed non-commercially available medications, and (3) durable medical equipment company owners that recruited and paid the patients so they could bring the false prescriptions to the pharmacy owners.
At trial, evidence established that patients were paid $100 to $150 per month for the use of their Medicare cards. Pharmacy owners testified that the scheme of using “compounding” was designed from the beginning to defraud Medicare. Unwilling to buy FDA-approved medication to fill those prescriptions, pharmacies “compounded” the aerosol medications by the gallons, and then billed Medicare. Patients testified at trial that they did not want the boxes of medicine and the only reason they went to the doctor with the DME owner was to receive cash kickbacks.
“We must vigorously enforce the federal laws that protect the fiscal integrity of the Medicare Program so that we may insure the viability of our health care program for generations to come,” said R. Alexander Acosta, the United States Attorney in Miami. Acosta noted that Medicare fraud has a substantial impact on the strength of the program designed to provide for the health and welfare of the seniors and disabled members of our community.
Mr. Acosta commended the investigative efforts of the U.S. Department of Health and Human Services, Office of the Inspector General, and the Federal Bureau of Investigation. The case was prosecuted by Kirk Ogrosky, Deputy Chief of the Fraud Section of the Department of Justice, and Jeffrey A. Neiman, Trial Attorney in the Fraud Section of the Department of Justice in Washington, DC.
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 onList your legal jobs on the LawFuel Network