$101 million in Medicare fraud charges

Authorities announce criminal health care fraud charges against 16 defendants for fraudulently billing Medicare approximately $101 million.

All-Med Billing Corp. Indictment, U.S. v. Mabel Diaz, et al

On May 22, 2007, a Miami federal grand jury returned a 46-count indictment against eight defendants in United States v. Mabel Diaz, et al., No. 07-20398- Cr-Ungaro. The indictment charges Mabel and Abner Diaz, wife and husband, with operating All-Med Billing Corp. (All-Med), a Miami medical billing company, and executing a scheme to submit tens of millions of dollars in fraudulent claims to Medicare from 1998 to 2004 for reimbursement for durable medical equipment (DME) and related services. The indictment alleges that All-Med submitted approximately $80 million in false claims on behalf of 29 DME companies. The claims were allegedly fraudulent in that the equipment had not been ordered by a physician and/or had never been delivered to a Medicare patient. As a result of the submission of the fraudulent claims, Medicare paid the DME companies approximately $56 million. The indictment also seeks forfeiture of the fraud proceeds and substitute assets, including real estate of the Diazes. The Diazes were additionally charged with conspiracy to launder the proceeds of the alleged All-Med billing fraud scheme. Also charged in the All-Med billing fraud scheme was All-Med employee Suleidy Cano.

Other defendants charged are Amry Garcia, Davel Hernandez, and Rene Raimundo Hernandez. They are charged with conspiring to defraud Medicare in their operation of A-1 Durable Medical Equipment and Supplies, Inc. (A-1), a Miami DME company. According to the indictment, A-1 received approximately $2.1 million in response to fraudulent claims that were submitted to Medicare by All-Med.

The indictment also charges defendants Jose Luis Palma Jr. and Luis Gonzalez with conspiracy and Medicare fraud in connection with the operation of Simply Medical Services Inc. (Simply Medical), a Miami DME company. In addition, Gonzalez was charged with Medicare fraud in relation to another DME company, Premier Medical Service. Inc. (Premier). As a result of fraudulent claims alleged to have been submitted by All-Med on behalf of Simply Medical and Premier, Medicare paid over $3.7 million.

If convicted of the conspiracy and health care fraud charges, each of the eight defendants faces a maximum punishment of 10 years imprisonment per count. The Diazes face an additional 20 years imprisonment on the money laundering charge.

Indictment: U.S. v. Jose Tomas Iglesias, et al.

On May 22, 2007, another indictment charged defendants Jose Tomas Iglesias, Marco Antonio Marrero, and Leslie Gonzalez, Case No. 07-20399-Cr- King, with conspiring to defraud Medicare in connection with the fraudulent submission of $6.8 million in DME-related claims during 2006. The claims concerned a Miami DME company named Bridge Medical Equipment Inc. According to the indictment, Medicare paid Bridge approximately $1 million in response to the bogus claims, which were for DME items that were neither prescribed by doctors nor delivered to Medicare patients.

Iglesias was also separately charged with several counts of illegally laundering the fraud proceeds through the cashing or depositing of various checks and with aggravated identity theft by using another's Florida driver's license in connection with the health care fraud scheme.

If convicted, the three defendants face 10 years imprisonment on the health care fraud charges. Iglesias faces up to 20 years imprisonment on each of the money laundering charges. Finally, Iglesias faces a mandatory consecutive two-year prison term on the aggravated identity theft charge.

Indictment: U.S. v. Alejandro De La Victoria

On May 22, 2007, defendant Alejandro De La Victoria, the owner of Precise Medical Services Inc., a Miami DME company, was indicted, Case No. 07-20397- Cr-Gold, on fraud charges for submitting approximately $3 million in fraudulent DME claims to Medicare during several months in 2006, and receiving approximately $1.4 million in payments. De La Victoria faces up to 10 years in prison on each of the six health care fraud charges.

Indictment: U.S. v. Maria Oliveros-Garay

On May 15, 2007, defendant Maria Oliveros-Garay was indicted on four counts of health care fraud in connection with a Medicare billing fraud involving Abue Medical Equipment, Inc., a Miami DME company. According to the indictment, Case No. 07-20377-Cr-Cooke, Oliveros-Garay submitted approximately $3.8 million in fraudulent DME-related claims to Medicare in 2006, of which Medicare paid approximately $1.5 million. If convicted, Oliveros-Garay faces up to 10 years imprisonment on each count.

Informations: U.S. v. Mario Mira and U.S. v. Eduardo Ruiz

On May 23, 2007, the U.S. Attorney's Office filed two separate informations against two individuals in separate DME-related fraud cases. In one case, Case No. 07-20405-Cr-Martinez, defendant Mario Mira was charged with one count of health care fraud in connection with Mario & Clara Medical Supply Inc., of Miami, a DME company that submitted at least $2.5 million in fraudulent DME claims to Medicare in 2006. Mira faces a maximum term of imprisonment of 10 years.

In the second case, Case No. 07-20406-Cr-Jordan, defendant Eduardo Ruiz was charged with one count of health care fraud in connection with EZ Medical Inc., a Tampa DME company. According to the Information, Ruiz caused the submission of approximately $5.3 million in fraudulent DME claims in 2005 by misappropriating and using the Medicare identification numbers of Miami-Dade beneficiaries. Medicare paid approximately $1.38 million on these claims. Ruiz faces a maximum prison term of 10 years.

Guilty Plea: U.S. v. Eredio Prieto

On May 24, 2007, defendant Eredio Prieto pled guilty in Case No. 07-20333- Cr-Huck, to one count of money laundering. The charge arose out of Prieto's use of a shell corporation, Royalty Group Investment Corp. (Royalty Group). According to court records, Prieto deposited proceeds of health care fraud, involving south Florida health care companies, into Royalty Group bank accounts and then engaged in financial transactions to launder approximately $147,000 in Medicare funds in 2006. Prieto faces a maximum of 20 years imprisonment. Sentencing is scheduled for Aug. 22, 2007.

Mr. Acosta commended the investigative efforts of the Federal Bureau of Investigation; the U.S. Department of Health and Human Services, Office of Inspector General, Atlanta Regional Office; the U.S. Immigration and Customs Enforcement, Miami; and Office of the Florida Attorney General. These cases are being prosecuted by Assistant U.S. Attorneys Marc Osborne, David Frank, Luis M. Perez, and Jeffrey Marcus.

A copy of this press release may be found on the Web site of the U.S. 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 Web site of the U.S. District Court for the Southern District of Florida at http://www.flsd.uscourts.gov/ or on http://pacer.flsd.uscourts.gov/.


The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News-Medical.Net.
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