Seven Miami-Area Residents Charged With $11 Million Medicare Fraud

LawFuel – Seven Miami-area residents have been indicted in connection with an $11 million Medicare fraud scheme involving HIV infusion clinics, Assistant Attorney General Alice S. Fisher of the Criminal Division and U.S. Attorney R. Alexander Acosta of the Southern District of Florida announced today.

Dr. Ana Alvarez, 54, Mariela Rodriguez, 39, Aisa Perera, 42, Beatriz Delgado, 48, Angel Rodriguez, 40, Sandra Mateos, 43, and Carmen Gonzalez, 33, were all charged today in federal district court in Miami with: conspiracy to defraud the United States, to cause the submission of false claims, to pay health care kickbacks, and conspiracy to commit health care fraud. The indictment also seeks forfeiture of assets held by all named defendants. Mariela Rodriguez, Perera, and Delgado also were charged with four counts of submitting false claims to the Medicare program. Alvarez also was charged with three counts of submitting false claims and Mariela Rodriguez was charged with one count of perjury.

According to the indictment, Mariela Rodriguez and Perera incorporated Saint Jude Rehab Center, Inc. (Saint Jude) in April 2003 as a medical clinic that purported to specialize in treating HIV patients. Delgado, a receptionist at Saint Jude, agreed to be incorrectly listed on filed corporate records as president and registered agent of Saint Jude. Mariela Rodriguez and Perera hired Dr. Alvarez to work at Saint Jude despite having no prior expertise in the clinic’s proclaimed specialty of treating HIV patients. Dr. Alvarez ordered unnecessary tests, signed medical analysis and diagnosis forms, and authorized treatments without regard to medical necessity, to make it appear that legitimate medical services were being provided to HIV patients receiving Medicare benefits.

The indictment further charges that during the conspiracy, Mariela Rodriguez, Perera, and Delgado withdrew cash from Saint Jude’s bank account for Angel Rodriguez, Mateos and Gonzalez, assistants at Saint Jude, to pay cash kickbacks of approximately $100 to $150 per visit to HIV patients. In return for the kickbacks, patients signed logs stating that they had received the treatments that were billed to Medicare, when in fact the patients had not received the claimed treatments.

From June 2003 through November 2003, Saint Jude billed approximately $11 million to the Medicare program under the Medicare provider numbers of Dr. Alvarez and Dr. Orestes Alvarez-Jacinto, receiving more than $8 million in payments for HIV infusion services that were not actually provided and services that were not medically necessary.

Dr. Orestes-Alvarez Jacinto, a former doctor at Saint Jude, pleaded guilty in June 2007 to conspiracy to commit health care fraud and was sentenced in October 2007 to 18 months in prison. In a related case, Rita Campos Ramirez, the medical biller employed by Saint Jude, pleaded guilty in August 2007 to a $170 million conspiracy to commit health care fraud. Sentencing is scheduled for later today.

If convicted on all charges, Mariela Rodriguez, Perera and Delgado each face maximum prison sentences of 35 years. Alvarez faces a maximum prison sentence of 30 years while Angel Rodriguez, Mateos and Gonzalez each face maximum prison terms of 15 years.

This case is being prosecuted by Trial Attorneys Hank Bond Walther and John K. Neal of the Criminal Division’s Fraud Section, with the investigative assistance of the FBI. The Medicare Strike Force is led by Deputy Chief Kirk Ogrosky of the Criminal Division’s Fraud Section and the office of U.S. Attorney R. Alexander Acosta of the Southern District of Florida.

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 http://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 http://www.flsd.uscourts.gov or on http://pacer.flsd.uscourts.gov.

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