Defendants Sentenced for Medicare Fraud Scheme

In Miami, judges have begun sentencing defendants convicted of playing a role in the Medicare fraud scheme. The Department of Health and Human Services (HHS) has initiated the Healthcare Fraud Prevention and Enforcement Action Team (HEAT), which is aimed at reducing Medicare and Medicaid fraud. The indictments include, but are not limited to, conspiracy to defraud the Medicare program, criminal false claims, and violations of the anti-kickback statutes. Last week, the authorities arrested 53 people in Detroit for similar offenses and had indicted over 250 nationwide.

Today, Judge Paul C. Huck sentenced Roberto Rodriguez to 97 months in prison for his role in the scheme, which involved HIV infusion services. Besides prison-time, Rodriguez was also ordered to pay over $9 million in restitution to the Medicare program. In March, Rodriguez plead guilty to healthcare fraud involving a medical center he co-owned–Midway Medical Center–stating he and his co-conspirators knowingly billed Medicare for procedures they did not administer and for drugs he did not prescribe.

According to the HHS, “[m]ost of the services allegedly provided to patients at Midway were billed to the Medicare program as treatments for thrombocytopenia, a disorder involving a low count of platelets in the blood.” After further investigation and admissions by Rodriguez, none of those patients had low platelets, and Rodriguez was aware of this. Rodriguez admitted to having chemists manipulate the blood samples to reflect low platelet levels prior to being sent to be tested by the laboratory. When he received the test results reflecting a low platelet count, he could prescribe the thrombocytopenia medications for the patients. Rodriguez admitted to defrauding Medicare in false claims totaling over $20 million.

Rodriguez defrauded Medicare in multiple clinics. His co-conspirators have also been sentenced to prison. This is the beginning of a string of individuals who will be convicted and sentenced under this nation-wide Medicare fraud scheme.

For more information, please call Abby Pendleton, Esq., Robert Iwrey, Esq., Adrienne Dresevic, Esq., Carey F. Kalmowitz, Esq. or Jessica L. Gustafson, Esq. at (248) 996-8510 or visit The HLP website.