Wednesday, December 17, 2008

Miami doctor sentenced to 30 years in Medicare HIV treatment scam

Doctors in the Banana Republic of Miami-Dade County are notorious for scamming the government. Story here.

MIAMI -- A Miami doctor has been sentenced to 30 years in prison -- one of the stiffest penalties given for Medicare fraud -- for her role in an HIV infusion fraud scheme.

A federal judge said Ana Alvarez-Jacinto lied about her role in the scam. Alvarez-Jacinto was sentenced Wednesday beyond the 22 years recommended by prosecutors. Sandra Mateos, a nurse who also participated, was sentenced to seven years.

The duo were found guilty in October for their role at a bogus AIDS clinic, one of 12 run by the Benitez brothers. The brothers, who were indicted for stealing $110 million from Medicare, are on the lam.

See article about the convictions here.

Evidence at trial established that both defendants worked at Saint Jude Rehab Center Inc. (St. Jude), a clinic that purported to specialize in treating HIV/AIDS patients. St. Jude was operated and owned by indicted fugitives Carlos Benitez and Luis Benitez, and managed by convicted co-conspirators Aisa Perera and Mariela Rodriguez.

Evidence at trial proved that between June and November 2003, Alvarez-Jacinto, with the assistance Mateos, ordered hundreds of medically unnecessary HIV infusion treatments at the clinic. Evidence at trial also established that HIV-positive Medicare patients were brought to the clinic by Carlos and Luis Benitez for the purpose of getting cash payments in exchange for allowing the clinic to bill for unnecessary treatments. Testimony at trial revealed that defendant Mateos and other co-conspirators paid the patients cash kickbacks of approximately $150 per visit. After patients had been paid, they agreed to allow Alvarez-Jacinto and her co-conspirators to prescribe, and sometimes administer, unnecessary infusion treatments. According to testimony at trial, St. Jude then billed Medicare for approximately $11 million for the unnecessary services. For those claims, Medicare paid more than $8 million to St. Jude.

I would think here it's Medicaid, not Medicare, fraud. Medicare is for the elderly. (But - who knows - I could be wrong here.) Usually people with HIV are treated through Medicaid if they don't have insurance through their employer.

See here also.

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