Miami doctor, nurse guilty of Medicare fraud
Oct 21, 2008
The brothers who owned the clinic involved in an $11 million Medicare scam fled to Cuba. A doctor and nurse who worked in the clinic were convicted of fraud.
BY JAY WEAVER
Miami Herald--October 21, 2008
A Miami doctor and nurse have been convicted of billing Medicare for millions of dollars in false claims for obsolete HIV therapy at a local clinic owned by three brothers who fled to Cuba to avoid prosecution.
Dr. Ana Alvarez-Jacinto and Sandra Mateos, found guilty by a Miami federal jury Friday, played key roles in an $11 million scam involving HIV-positive patients who received kickbacks in exchange for letting the clinic use their Medicare numbers to bill the federal program.
The two women who opened St. Jude Rehab Center as partners with Carlos, Jose and Luis Benitez — fugitives charged in a separate indictment — had already pleaded guilty to fraud this year. Mariela Rodriguez and Aisa Perera, who ran St. Jude from June to November 2003, collected $8 million from the false Medicare claims.
Authorities say the Benitez brothers — jailed in Cuba on immigration violations last month — operated a dozen HIV treatment clinics that billed Medicare a total of $119 million and received $84 million in payments between 2001 and 2004. They fled to Cuba before their fraud indictment was unsealed last June.
Medicare has continued to allow the outdated HIV infusion services and to pay hundreds of millions of dollars yearly for the treatments because the agency still considers them ”reasonable and necessary” — despite the fact they’ve been rendered obsolete by antiretroviral drugs taken orally. More than a dozen of the Benitez brothers’ co-conspirators — medical doctors, physician’s assistants, clinic administrators, billing operators — have been convicted of defrauding the federal health insurance program for the elderly and disabled.
ON THE LAM
One woman absent from the recent St. Jude trial, Carmen Gonzalez, a nursing assistant, is suspected of having fled to Cuba with her father, Enrique Gonzalez, who was indicated in a separate Medicare fraud case.
At the two-week trial, prosecutors presented evidence showing that Alvarez-Jacinto and Mateos ordered hundreds of unnecessary HIV infusion treatments at the clinic. The physician wrote prescriptions for HIV-positive patients brought to St. Jude by Carlos and Luis Benitez. The patients received $150 per visit.
But while the physician and nurse were found guilty by the federal jury, Beatriz Delgado, a receptionist, and Angel Rodriguez, a medical assistant, were acquitted.
”There’s no question that Medicare fraud is a huge problem in South Florida, but you cannot claim that everybody who is working in a clinic is part of that fraud,” said attorney Frank Quintero, who represented Angel Rodriguez. “We had a very smart jury in this trial and they saw through the lack of evidence as far as my client is concerned.”
GUILTY PLEAS
Last month, a physician’s assistant who taught Alvarez-Jacinto and other physicians how to prescribe obsolete HIV therapy pleaded guilty. Thomas McKenzie, the right-hand man at the Benitez brothers’ clinics in Miami-Dade, testified at the recent trial.
The brothers immigrated in 1995 and became U.S. citizens five years later, just before launching their alleged conspiracy to rip off the taxpayer-funded healthcare program.
Prosecutors say the brothers funneled tens of millions of Medicare dollars through sham companies to buy hotels, homes, cars, boats, horses, a helicopter and even a water park, all in the Dominican Republic. FBI agents have teamed up with Dominican police to seize their assets under a U.S. court order.