The U.S. Department of Justice said the owners of several healthcare companies have been sentenced to prison terms during the first three weeks of January for filing a total of $56.6 million worth of fraudulent Medicare claims, according to a report in the South Florida Business Journal.
Centers for Medicare and Medicaid Services (CMS) data shows that Miami-Dade County in Florida paid more in durable medical equipment (DME) claims than 44 other states, and that only some of the most populous states in the country--including California, Texas, New York, Michigan, and Ohio--exceeded Miami-Dade's billings. Also, an average Medicare patient in Miami-Dade County allegedly received $6,200 worth of DME every year, based on paid amounts, though patients throughout the rest of the United States average about $1,200 a year.
A task force set up in Miami to reduce fraud brought the cases against:
- Luis Soto, 41, was sentenced to seven years, three months, for operating Ocean Medical Equipment and ten other companies that billed Medicare $47 million for items such as oxygen concentrators, nebulizers, and wheelchairs that were never provided.
- Noel Rodriguez, 50, was sentenced to four years, three months for operating OxyCare of Miami and submitting more than $1.2 million in false claims for such items as hospital beds and pressure-reducing mattresses.
- Rosabel Gonzalez, 32, was sentenced to two years, six months for operating Genesis Associates Group and submitting $1.5 million in false claims, mostly power pressure-reducing mattresses and orthotics.
- Christian Vasquez, 22, was sentenced to three years, five months for being the nominal owner of Tamiami Medical Supply, which submitted $1.2 million in phony claims.
- Maria De La Serna, 55, was sentenced to 19 months for owning and operating Respiratory One Equipment, which billed Medicare for $345,000 in fraudulent claims.
- Ariel Betancourt, 35, was sentenced to two years for being the named owner of Lincoln Medical Supply, which submitted more than $480,000 in false claims.
- José Prieto, 58, was sentenced to three years, five months for operating Coral Way Medical, an HIV infusion clinic that billed $900,000 in fraudulent claims.
- Armando Jorge Herrera, 27, was sentenced to three years for the same operation.
- Reinaldo Lopez, 40, was sentenced to three years, 10 months for owning and operating Reny Medical Equipment, which submitted more than $450,000 in false claims for prosthetics and ostomy supplies.
