Navigation Links
Detroit Clinic Owner and Manager Plead Guilty to Medicare Fraud Charges
Date:9/24/2009

WASHINGTON, Sept. 24 /PRNewswire-USNewswire/ -- Clinic owners and operators Jose Martinez and Denisse Martinez pleaded guilty today in U.S. District Court in Detroit to participating in a conspiracy to defraud the Medicare program, Assistant Attorney General Lanny A. Breuer of the Criminal Division, U.S. Attorney Terrence Berg of the Eastern District of Michigan and Daniel R. Levinson, Inspector General of the Department of Health & Human Services (HHS) announced.

Jose Martinez, 33, and Denisse Martinez, 27, each pleaded guilty to one count of conspiracy to commit health care fraud before U.S. District Judge Victoria Roberts. At sentencing, which is scheduled for Feb. 18, 2010, both defendants face a statutory maximum of 10 years in prison and a $250,000 fine.

According to court documents, Jose Martinez, in September 2006, opened RDM Center Inc., a Canton, Mich., medical clinic purporting to specialize in providing injection and infusion services to Medicare beneficiaries. Jose Martinez's then-wife, Denisse Martinez, managed and operated the clinic.

In their pleas, both defendants acknowledged that they hired a physician and other employees to work at RDM Center in order to create the appearance that the clinic was a legitimate health care facility providing necessary services to patients, when in fact, everyone working at the clinic knew that it was operated for the sole purpose of defrauding Medicare.

In their pleas, both Jose and Denisse Martinez admitted that during the time that the RDM Center was open, the clinic routinely billed the Medicare program for services that were medically unnecessary or never provided. Both defendants admitted that they purchased only a small fraction of the medications for which the clinic billed the Medicare program. Both defendants also admitted that patients were prescribed medications at the clinic based not on medical need, but on which medications were likely to generate Medicare reimbursements.

Denisse Martinez admitted in her plea that, despite having no medical training, she completed the clinic's patient records by filling in, among other things, the "diagnosis" and "treatment" sections of the patient charts, which were then provided to the physician for his signature.

According to information contained in the plea documents, Medicare beneficiaries were not referred to RDM Center by their primary care physicians, or for any other legitimate medical purpose, but rather were recruited to come to the clinic through the payment of kickbacks. In exchange for their kickbacks, the Medicare beneficiaries would visit the clinic and sign false documents indicating that they had received the services billed to Medicare. Kickbacks came in the form of cash and prescriptions for controlled substances.

Jose Martinez stated in his plea that he provided cash to a patient recruiter for the purpose of paying Medicare beneficiaries to sign paperwork indicating that they had received infusion and injection therapy services which they did not in fact receive. Denisse Martinez stated in her plea that she understood the patients at the clinic were induced to visit RDM Center through the payment of kickbacks. Both defendants further admitted to being aware that certain Medicare beneficiaries demanded that they be provided prescription drugs, including Vicodin, in exchange for their participation in the fraudulent scheme and that such drugs were in fact provided.

Both defendants admitted in their pleas that between approximately November 2006 and March 2007, they and their co-conspirators filed $970,631 in false and fraudulent claims with the Medicare program. According to court documents, Medicare actually paid more than $649,000 of those false claims.

The case is being prosecuted by Trial Attorneys John K. Neal and Benjamin D. Singer of the Criminal Division's Fraud Section and by Special Assistant U.S. Attorney Thomas W. Beimers of the Eastern District of Michigan. The FBI and the HHS Office of Inspector General (HHS-OIG) conducted the investigation. The case was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division's Fraud Section and the U.S. Attorney's Office for the Eastern District of Michigan.

Since the inception of Strike Force operations in March 2007 - Miami (Phase One), Los Angeles (Phase Two), Detroit (Phase Three) and Houston (Phase Four) - the Strike Force has obtained indictments of 300 individuals and organizations that collectively have billed the Medicare program for more than $680 million. In addition, HHS's Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

Each of the Medicare Fraud Strike Force teams are led by a federal prosecutor from the Criminal Division's Fraud Section or the U.S. Attorney's Office. Each team has an agent from the FBI and HHS-OIG.

To learn more about the Health Care Fraud Prevention and Enforcement Action Team, or "HEAT," go to: www.stopmedicarefraud.gov.


'/>"/>
SOURCE U.S. Department of Justice
Copyright©2009 PR Newswire.
All rights reserved

Related medicine news :

1. Tickets Still Available for Detroit Uncorked;
2. Detroit Metro Tower Air Traffic Controllers File Lawsuit Alleging Improper Mold Removal and Health Effects
3. McKesson Corporation CEO to Address the Detroit Economic Club on Preserving Our Healthcare System and Improving Quality of Life
4. Haile Gebrselassie Coming to Detroit for Free Press/Flagstar Marathon
5. Saturn Shows Its Commitment to Health and Fitness by Becoming Expo Title Sponsor for The Detroit Free Press/Flagstar Marathon
6. EPA Awards $40,000 Grant to Detroit Health Department for Asthma Program
7. Ilitch Brings New Brand of Pilates to Metro Detroit With Opening of Studio in West Bloomfield
8. Detroit Homeless Men Adopt Local Families for Christmas
9. University of Detroit Mercy School of Dentistry Moves to Larger Facility on New Corktown Campus
10. Old Newsboys Goodfellow Fund of Detroit Has REACHED and EXCEEDED ITS GOAL of $1.375 Million
11. Dorsey Schools, Detroit Areas Preeminent Career Training School, Opens a Fifth Campus in Farmington Hills
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/23/2017)... ... February 23, 2017 , ... Rare Disease ... will be participating in Rare Disease Day events, hosted by the Rare Disease ... Disease Report, a website, weekly e-newsletter and quarterly publication, will be conducting interviews ...
(Date:2/23/2017)... ... 23, 2017 , ... Los Angeles-based weight loss surgeon Michael Feiz, M.D., F.AC.S. ... Not to Hot,” which will begin airing on February 24, 2017. The show chronicles ... the 2012 reality television series, “Here Comes Honey Boo Boo.” The earlier series from ...
(Date:2/23/2017)... NJ (PRWEB) , ... February 23, 2017 , ... ... in thought leadership , media relations, content marketing, social media management, corporate ... several clients already in the state and in nearby New Hampshire, Massachusetts and ...
(Date:2/23/2017)... Angeles, California (PRWEB) , ... February 23, 2017 ... ... Global Sports Development will host a diverse symposium on “Doping in ... of Law and Sheppard Mullin Richter & Hampton LLP. The symposium will be ...
(Date:2/23/2017)... ... 2017 , ... Pink Pig Publishing LLC announces the launch ... the world from different perspectives. By providing a place for people of all ... empathy, and find greater happiness. , "Our approach to structuring content is ...
Breaking Medicine News(10 mins):
(Date:2/23/2017)... Research and Markets has announced the addition of the ... report to their offering. ... The Global Endoscopy Market is poised to grow ... reach approximately $47.6 billion by 2025. This industry ... segments on global as well as regional levels presented in the ...
(Date:2/23/2017)... Ga., Feb. 23, 2017  MiMedx Group, Inc. (NASDAQ: ... tissue and patent-protected processes to develop and market advanced ... Spine, Sports Medicine, Ophthalmic, and Dental sectors of healthcare, ... and full year ended December 31, 2016. ... Revenue is a 31% increase over full year 2015 ...
(Date:2/23/2017)... Feb. 23, 2017   SeraCare Life Sciences ... in vitro diagnostics manufacturers and clinical laboratories, is ... Implementation of NGS-Based Tests" to be hosted by ... at 11am Eastern Standard Time (US). ... the need for improved performance and global standardization ...
Breaking Medicine Technology: