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HIV Infusion Clinic Administrator Sentenced to 30 Months in Prison For Health Care Fraud

WASHINGTON, July 10 /PRNewswire-USNewswire/ -- Miami resident Aisa Perera, 42, was sentenced today to 30 months in prison for her role in an $11 million scheme to defraud the Medicare program, Acting Assistant Attorney General Matthew Friedrich of the Criminal Division and U.S. Attorney R. Alexander Acosta of the Southern District of Florida announced.

Perera was sentenced in the U.S. District Court for the Southern District of Florida by Judge Federico A. Moreno. In addition to the prison sentence, Judge Moreno ordered that the defendant be placed on three years of supervised release following her release from prison and pay $8,289,286 in restitution to the U.S. Department of Health and Human Services (HHS).

On April 23, 2008, Perera pleaded guilty to one count of conspiracy to commit health care fraud, in connection with her role as administrator of Saint Jude Rehab Center Inc., an HIV clinic that purported to provide HIV infusion services to Medicare beneficiaries. In connection with her plea, Perera admitted that in June 2003, she opened Saint Jude with three co-conspirators who owned and operated several HIV clinics in the Miami area. The co-conspirators, Carlos, Luis and Jose Benitez were charged separately with health care fraud and money laundering crimes in an indictment unsealed on June 11, 2008. According to the separate indictment, these co-conspirators are alleged to have provided the money and staff necessary to open Saint Jude, the Medicare patients that Saint Jude would bill to the Medicare program and transportation for the HIV patients who visited Saint Jude. In return, the co-conspirators are alleged to have received 60 percent of all payments Saint Jude received from the Medicare program.

Perera also admitted that between June 2003 and November 2003, Saint Jude submitted approximately $11.3 million in fraudulent claims to the Medicare program for HIV infusion services that were either never provided or not medically necessary. Medicare paid more than $8.2 million of the $11.3 million in fraudulent claims. As part of the conspiracy, Perera and her co-defendants allegedly paid patients who attended Saint Jude approximately $100 to $150 in cash kickbacks per visit and then hired a medical biller for the purpose of altering the bills being submitted to the Medicare program to make them appear legitimate. The co-defendants, Mariela Rodriguez, Beatriz Delgado, Carmen Gonzalez and Sandra Mateos, were indicted along with Perera on April 2, 2008.

In a related case, on Aug. 28, 2007, medical biller Rita Campos-Ramirez pleaded guilty to one count of conspiracy to commit health care fraud and one count of submitting false claims to the Medicare program, in connection with her participation in the Saint Jude fraud scheme and approximately 74 other HIV infusion fraud schemes. In connection with her plea, Campos-Ramirez admitted that over the course of three and a half years, she submitted approximately $170 million in fraudulent bills to the Medicare program on behalf of approximately 75 health clinics that purported to provide HIV infusion services to Medicare beneficiaries. Of the $170 million that was billed, approximately $105 million was paid by Medicare. On April 2, 2008, the Honorable Alan S. Gold sentenced Campos-Ramirez to 12 years in prison.

In another related case, on June 12, 2007, Dr. Orestes Alvarez-Jacinto pleaded guilty to one count of conspiracy to commit health care fraud in connection with his participation in the Saint Jude fraud scheme. In connection with his plea, Alvarez-Jacinto admitted to authorizing and approving the use of the drug WinRho, along with a mix of various vitamin supplements, for each HIV patient he was seeing, knowing that the HIV patients did not need WinRho and that the drug could actually harm them. During this period, Alvarez-Jacinto signed bills for WinRho treatments that misrepresented the amount of drugs actually administered to the patients. He also signed inflated bills for treatments that were medically unnecessary for the purpose of forwarding those bills to Medicare for payment. On Oct. 2, 2007, the Honorable Patricia A. Seitz sentenced Alvarez-Jacinto to 18 months in prison.

The Saint Jude case was prosecuted by Trial Attorneys Hank Bond Walther and John K. Neal of the Criminal Division's Fraud Section in Washington, D.C., with the investigative assistance of the FBI and the HHS Office of Inspector General. The case was brought as part of the Medicare Fraud Strike Force, supervised by Deputy Chief Kirk Ogrosky of the Criminal Division's Fraud Section and U.S. Attorney Acosta of the Southern District of Florida. From investigations opened during the period of strike force operations between March and October of 2007, federal prosecutors have indicted 82 cases with 142 defendants in South Florida. Collectively, these defendants fraudulently billed the Medicare program for more than $492 million.

SOURCE U.S. Department of Justice
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