HOW PATHETIC WE ARE BLAMING THE UNDOCUMENTED IMMIGRANTS FOR DRAINING THE SOCIAL SERVICES SUCH AS MEDICARE, WELFARE. I EXPOSED JUST A FEW RECENTLY CASES AND WE TALKING MILLIONS NOT HUNDREDS IN FRAUD.

FIVE CHARGED IN SEPARATE HEALTH CARE FRAUD CASES, TOTALING $39 MILLION IN FRAUD

R. Alexander Acosta, United States Attorney for the Southern District of Florida, Jonathan I. Solomon, Special Agent in Charge, Federal Bureau of Investigation, Miami Field Office, Melody Jackson, Special Agent in Charge, United States Department of Health and Human Services, Office of Inspector General, Atlanta Regional Office, Anthony V. Mangione, Special Agent in Charge, U.S. Immigration and Customs Enforcement, and Bill McCollum, Attorney General, State of Florida, announced criminal health care fraud charges against five (5) defendants for fraudulently billing Medicare approximately $39 million.

Indictment, U.S. v. Nelson Martin and Aurelio Benavides

On September 25, 2007, a Miami federal grand jury returned a five (5) count indictment against two defendants in United States v. Nelson Martin and Aurelio Benavides, No. 07-20765-Cr-Huck. The Indictment charges Nelson Martin and Aurelio Benavides, with owning and operating Professional Gluco Services, Inc. (“Professional Gluco”), a Miami durable medical company, and executing a scheme to submit tens of millions of dollars in fraudulent claims to Medicare from November 2005 to September 2006 for reimbursement for durable medical equipment (DME) and related services. The Indictment alleges that the defendants submitted approximately $14.3 million in false claims on behalf of Professional Gluco. 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 Professional Gluco approximately $1.3 million.

If convicted of the health care fraud charges, the defendants face a maximum punishment of 10 years’ imprisonment per count.

Indictment: U.S. v. Sahily Penichet

On September 17, 2007, defendant Sahily Penichet, the owner of H & B Medical Services, Inc., a Miami DME company, was indicted, Case No. 07-20749-Cr-Ungaro, on fraud charges for submitting approximately $5.4 million in fraudulent DME claims to Medicare from November 2005 through June 2006, and receiving approximately $1.25 million in payments. Penichet faces up to 10 years in prison on each health care fraud charge.

Information: U.S. v. Adam David Cruz

On August 29, 2007, the U.S. Attorney’s Office filed an Information against defendant Adam David Cruz on DME-related fraud charges, Case No. 07-20679-Cr-Cooke. Cruz was charged with one count of health care fraud in connection with Amerihealth Services, Inc., of Miami, a DME company that submitted approximately $10.3 million in fraudulent DME claims from August 2004 through August 2005. Cruz faces a maximum term of imprisonment of 10 years.

Information: U.S. v. Amaury Oquendo

On August 28, 2007, the U.S. Attorney’s Office filed an Information against defendant Amuary Oquendo on DME-related fraud charges, Case No. 07-20676-Cr-Gold. Oquendo was charged with one count of health care fraud in connection with A & M Medical Services, Inc., of Miami, a DME company that submitted approximately $8.45 million in fraudulent DME claims to Medicare from June 2005 through July 2006. Oquendo faces a maximum term of imprisonment of 10 years.

Sentencing: U.S. v. Mario Mira

On September 24, 2007, the Honorable Jose E. Martinez sentenced defendant Mario Mira, Case No. 07-20405-Cr-Martinez, to twenty-four months in prison in connection with Mira’s plea of guilty to a DME-related fraud charge. Mira, the owner of Mario & Clara Medical Supply, Inc., of Miami, a DME company, was responsible for submitting approximately $2.5 million in fraudulent DME claims to Medicare in 2006.

Guilty Pleas: U.S. v. Jose Tomas Iglesias, et al.

In August 2007, defendants Jose Iglesias, Leslie Gonzalez, and Marco Marrero pled guilty in 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. (“Bridge Medical”). Medicare paid Bridge Medical 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 also pled guilty to a separate money laundering charge related to the health care fraud proceeds. The three defendants face 10 years’ imprisonment on the health care fraud convictions. Iglesias faces up to 20 years’ imprisonment on the money laundering conviction.

Mr. Acosta commended the investigative efforts of the Federal Bureau of Investigation, the United States 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. Attorney Jeffrey E. Marcus.