Thursday, January 24, 2008

$56.6 million MEDICARE FRAUD.....

9 healthcare firm owners sent to prison

Owners of nine Miami healthcare companies have been sentenced to prison in the past two weeks in a string of cases that reveal the area still leads the nation in healthcare fraud, federal prosecutors announced Wednesday.

Medicare data shows that Miami-Dade County alone had more paid durable medical equipment claims than 44 states combined. Only the most populous states -- California, Texas, New York, Michigan and Ohio -- bill Medicare more than does Miami-Dade for DME claims.

The average Medicare recipient in Miami-Dade each year is named in paid DME claims worth $6,200. In the rest of the nation, the average is $1,200.

A special Medicare Fraud Task Force has been set up in Miami to cut back on the massive fraud, and it was the task force that brought the cases announced Wednesday.

Together, the nine filed fraudulent claims with Medicare for $56.6 million for unnecessary durable medical equipment and infusion therapy, the U.S. Department of Justice said in a press release.

The defendants:

• Luis Soto, 41, sentenced to seven years, three months for operating Ocean Medical Equipment and 10 other companies that billed Medicare for such items as oxygen concentrators, nebulizers and wheelchairs that were never provided. He was responsible for $47 million in false claims.

• Noel Rodriguez, 50, sentenced to four years, three months, for his operations of OxyCare of Miami that submitted over $1.2 million in false claims for such items as hospital beds and pressure-reducing mattresses.

• Rosabel Gonzalez, 32, sentenced to two years, six months, for using Genesis Associates Group to submit $1.5 million in false claims, much of which were for power air mattresses.

• Christian Vasquez, 22, sentenced to three years, five months. He was the nominal owner of Tamaimi Medical Supply, which submitted $1.2 million in phony claims.

• Maria De La Serna, 55, sentenced to 19 months for owning and operating Respiratory One Equipment, which billed Medicare for $345,000 in fraudulent claims.

• Ariel Betancourt, 35, sentence to two years. She was the named owner of Lincoln Medical Supply, which submitted more than $480,000 in fake claims.

• José Prieto, 58, sentenced to three years, five months for operating Coral Way Medical, an HIV infusion clinic which billed fraudulently in $900,000 worth of claims for expensive infusions. Armando Jorge Herrera, 27, was sentenced to three years for the same operation.

• Reinaldo Lopez, 40, sentenced to three years, 10 months for owning and operating Reny Medical Equipment, which submitted more than $450,000 in false claims.

Prosecutors in the cases were Kirk Ogrosky, Ryan Stumphauser, Randy Katz, John S. Darden, Jerrob Duffy and John Cunningham.

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