TWO DOCTORS AND TWO MEDICAL ASSISTANTS PLEAD GUILTY IN $10 MILLION MEDICARE
FRAUD SCHEME
WASHINGTON—Four Miami-area residents pleaded guilty today in connection with
a $10 million Medicare fraud scheme involving HIV infusion clinics, Acting
Assistant Attorney General Rita M. Glavin of the Criminal Division and U.S.
Attorney R. Alexander Acosta of the Southern District of Florida announced
today.
Dr. Roberto Rodriguez, 54; Dr. Carlos Garrido, 69; Gonzalo Nodarse, 38; and
Alexis Carrazana, 41; all pleaded guilty before U.S. District Judge Paul C. Huck
to one count of conspiracy to commit health care fraud. All four defendants
admitted to working at Midway Medical Center Inc. (Midway), a Miami clinic that
purported to specialize in the treatment of HIV patients.
According to the plea documents, Rodriguez was a co-owner of and practicing
physician at Midway. Rodriguez admitted that he and his co-conspirators
routinely billed the Medicare program for services that were medically
unnecessary and, in many instances, never provided. Rodriguez admitted to
purchasing only a small fraction of the medication that was purportedly being
administered to Midway’s patients.
Most of the services provided to patients at Midway were billed to the
Medicare program as treatments for a diagnosis of thrombocytopenia, a disorder
involving a low count of platelets in the blood. According to the plea
documents, none of Midway’s patients actually had low blood platelet counts.
Rodriguez admitted that to make it appear that the patients actually had low
platelet levels, he and his co-conspirators used chemists to manipulate the
blood samples drawn from Midway’s patients before the blood was sent to a
laboratory for analysis. In his plea, Rodriguez admitted to ordering that
patients at Midway receive medications to treat thrombocytopenia despite knowing
that the laboratory results had been falsified and the patients did not actually
have that condition.
Midway was not the only clinic where Rodriguez purported to treat HIV
patients with injection and infusion therapies. In his plea, Rodriguez admitted
that he was listed as a medical director and practicing physician for five other
Miami-area HIV infusion clinics between approximately October 2003 and February
2005, where he engaged in similar misconduct. Specifically, Rodriguez admitted
he and his co-conspirators billed the Medicare program for HIV injection and
infusion services that Rodriguez knew were medically unnecessary and, in some
instances, never actually provided. Rodriguez admitted to causing more than $20
million in false claims to be submitted to the Medicare program at all of his
clinics, including Midway.
Like Rodriguez, Garrido was a part-owner and practicing physician at Midway.
In his plea, Garrido admitted that he and his co-conspirators routinely billed
the Medicare program for services that were medically unnecessary and, in many
instances, never provided. Garrido admitted to purchasing only a small fraction
of the medication that was purportedly being administered to Midway’s patients.
Garrido ordered that patients be treated with medications he knew they did not
need and that, in many instances, he knew the clinic did not have available to
provide to the patients. Garrido admitted to working at Midway for approximately
eight months before the clinic closed, during which time he admitted to
submitting more than $1 million in fraudulent claims to the Medicare
program.
Nodarse and Carrazana worked at Midway as medical assistants. In their pleas,
the two assistants admitted to making false entries in medical records
indicating that they had provided medications on particular dates and in
particular dosages to patients, when, in fact, they had not provided
medications. The medical assistants also admitted to being fully aware that
blood samples drawn from Midway’s patients were tainted to make it appear that
the patients had conditions they did not have. Both assistants admitted to
administering medications to patients that they knew the patients did not need.
Nodarse, who worked at Midway throughout its existence, admitted to conspiring
to submit more than $10 million in false and fraudulent claims for HIV infusion
services allegedly provided at the clinic.
The case is being prosecuted by Trial Attorney John K. Neal of the Criminal
Division’s Fraud Section. The FBI and the Department of Health and Human
Services, Office of Inspector General, conducted the investigation. The case was
brought as part of the Medicare Fraud Strike Force (MFSF), supervised by Deputy
Chief Kirk Ogrosky of the Criminal Division’s Fraud Section and U.S. Attorney
Acosta of the Southern District of Florida. Since the inception of MFSF
operations, federal prosecutors have indicted 106 cases with 192 defendants in
both Los Angeles and Miami. Collectively, these defendants fraudulently billed
the Medicare program for more than half a billion dollars
