Wednesday, June 11, 2008
Another Charged in $110 Million Health Care Fraud Scheme. Isn't Just the Tip of the Iceberg and List going on and on.
WASHINGTON – Three Miami area brothers who allegedly financed 11 corrupt HIV infusion clinics and a physician’s assistant who worked at those clinics have been charged in a $110 million HIV infusion fraud scheme, the Department of Justice’s Criminal Division and the U.S. Attorney’s Office for the Southern District of Florida announced today.
The indictment alleges that between January 2001 and November 2004, Carlos and Luis Benitez conspired to submit approximately $110 million in false and fraudulent claims to the Medicare program for HIV infusion services allegedly provided at 11 corrupt HIV infusion clinics that they owned and controlled. As part of the scheme, Carlos and Luis Benitez referred Medicare beneficiaries to the clinics and directed the beneficiaries be paid kickbacks to induce them to claim they received legitimate services at the clinics when in fact the HIV infusion services were either not provided or were not medically necessary. The HIV infusion clinics that they owned and controlled were: AH Medical Office Inc.; Advanced Medical Rehabilitation Center Inc.; Best Medi Corp.; Physician’s Health Med-Care; Physician’s Med-Care Inc.; Saint Jude Rehab Center Inc.; Global Med-Care Corp.; CNC Medical Corp.; G&S Medical Centers Inc.; Karla Medical Services Inc.; and Best Medicare Inc.
The indictment alleges that Jose Benitez owned and operated one of the eleven clinics, Advanced Medical, and assisted in submitting approximately $10 million of the false and fraudulent claims to the Medicare program for HIV infusion services that were not provided and for services that were not medically necessary. Thomas McKenzie was a physician’s assistant at the HIV infusion clinics owned and operated by Carlos, Luis and Jose Benitez. The indictment alleges that, at the direction of Carlos, Luis and Jose Benitez, McKenzie was responsible for training physicians and providers in how to make it appear that legitimate and appropriate medical services were being provided as well as overseeing the preparation of documents to make it appear that the services were actually rendered and medically necessary.
After obtaining the proceeds from their crimes, the indictment alleges that Carlos, Luis, and Jose Benitez engaged in a scheme to launder those proceeds by, among other things, transferring millions of dollars in proceeds to sham "marketing" and "management" companies that they owned and controlled and by transferring proceeds among the corrupt HIV infusion clinics.
Carlos Benitez, Luis Benitez, Jose Benitez, and Thomas McKenzie were charged with conspiracy to defraud the United States, to cause the submission of false claims to the Medicare program, and to pay health care kickbacks; conspiracy to commit health care fraud; and submitting false claims to the Medicare program. Carlos, Luis and Jose Benitez were charged with conspiracy to launder the proceeds of their crimes, and Carlos and Luis Benitez were each charged with money laundering. The indictment also seeks forfeiture of assets held by all defendants. Carlos and Luis Benitez each face a maximum sentence of 155 years in prison, Jose Benitez faces a maximum of 40 years, and Thomas McKenzie faces a maximum of 50 years.
This case is being prosecuted by Trial Attorneys Hank Bond Walther and John K. Neal of the Criminal Division’s Fraud Section, as well as Laurel Loomis Rimon and Constantine Lizas of the Criminal Division’s Asset Forfeiture and Money Laundering Section, with the investigative assistance of the FBI and the Department of Health and Human Services Office of the Inspector General. The case was brought as part of the Medicare Fraud Strike Force that has been operating in Miami since March 2007. The Strike Force is led by Deputy Chief Kirk Ogrosky of the Criminal Division’s Fraud Section in Washington, D.C., and the office of U.S. Attorney R. Alexander Acosta of the Southern District of Florida.