R. Alexander Acosta, United States Attorney for the Southern District of Florida, and Jonathan I. Solomon, Special Agent in Charge, Federal Bureau of Investigation, Miami Field Office, announced that a jury today convicted defendants, Diana Sotto, an owner of All Medical Billing Solutions, Inc., a medical billing company, and Sandra Galvez, a former medical assistant at an HIV clinic in the Southern District of Florida, on all three applicable counts of a federal Indictment, charging them with conspiracy to defraud the United States and to pay health care kickbacks, in violation of Title 18, U.S.C., Section 371; conspiracy to commit health care fraud, in violation of Title 18, U.S.C., Section 1349; and conspiracy to launder money, in violation of Title 18, U.S.C., Section 1956.
According to the evidence at trial, the medical clinic Project New Hope defrauded Medicare of more than $2.8 million between September 2004 and September 2005. The clinic claimed to specialize in the treatment of HIV patients. The patients who attended the clinics were, in fact, HIV positive. The clinic fraudulently billed Medicare for dosages of expensive HIV medications, including Neupogen, Procrit, Acthar, and Fuzeon. Most patients did not receive the medication for which Medicare was billed. In addition, clinic personnel payed kickbacks to Medicare beneficiaries to induce them to continue to attend the clinics.
The evidence revealed that defendant Sotto owned the company that submitted the fraudulent bills to Medicare. Sotto received more than $600,000 in fraudulent proceeds, the majority of which she laundered through five shell corporations to disguise the extent of the payments and to make it appear that Project New Hope was paying Sotto for consulting services and investment advice, services that had not in fact been rendered. Defendant Galvez falsified therapy sheets in the patients’ files to make it appear that the patients were receiving medications as billed to Medicare. In truth, however, patients were not receiving the medications as noted on the sheets and billed to Medicare. Galvez also paid kickbacks to patients. In turn, Project New Hope paid Galvez over $100,000 for her year of part-time work as a medical assistant, of which $30,000 was laundered through a shell corporation to disguise the extent of the compensation.
The trial lasted two weeks before the Honorable Cecilia M. Altonaga. The defendants face a maximum punishment of 5 years’ imprisonment on the conspiracy to defraud the United States and to pay health care kickbacks, 20 years’ imprisonment on the conspiracy to commit health care fraud, and 20 years’ imprisonment on the money laundering count.
Five other defendants pleaded guilty before trial either to conspiracy to defraud the United States and to pay health care kickbacks or to conspiracy to commit health care fraud. These defendants are Luis Manuel Fernandez, Maria Loriga, Beatriz Fernandez, Manuel Ivan Perez, and Walter Lefurge. The evidence established that Luis Manuel Fernandez managed the clinic’s day-to-day operations and paid kickbacks to patients; Loriga and Beatriz Fernandez provided fraudulent forms to patients to assist with the fraud and paid kickbacks to patients; Perez recruited patients and paid them kickbacks; and Lefurge served as a purported patient, permitting Project New Hope to bill Medicare for services not actually rendered to him, and then subsequently lied to FBI agents to cover up the conspiracy.
Mr. Acosta commended the investigative efforts of the Federal Bureau of Investigation in the cases involving purported HIV infusion clinics in the Southern District of Florida. The case was prosecuted by Assistant United States Attorneys Marc Osborne and Jeffrey Marcus, with the assistance of Abigail Lyle, a legal intern in the United States Attorney’s office.
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.