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Nine Miami Defendants in Strike Force Cases Sentenced for $56.5 Million in Medicare Fraud
Date:1/23/2008

WASHINGTON, Jan. 23 /PRNewswire-USNewswire/ -- Assistant Attorney General Alice S. Fisher of the Criminal Division and U.S. Attorney R. Alexander Acosta of the Southern District of Florida announced today that owners of nine separate Miami-based health care corporations have been sentenced to prison terms within the past two weeks. Collectively, the nine defendants filed fraudulent claims with Medicare for $56,599,832 worth of unnecessary durable medical equipment (DME) and infusion therapy.

The nine defendants sentenced in Miami are: (1) Luis Soto, 41, sentenced to 87 months in prison; (2) Noel Rodriguez, 50, sentenced to 51 months in prison; (3) Rosabel Gonzalez, 32, sentenced to 30 months in prison; (4) Christian Vasquez, 22, sentenced to 41 months in prison; (5) Maria De La Serna, 55, sentenced to 19 months in prison; (6) Ariel Betancourt, 35, sentenced to 24 months in prison; (7) Jose Prieto, 58, sentenced to 41 months in prison; (8) Armando Jorge Herrera, 27, sentenced to 36 months in prison; and (9) Reinaldo Lopez, 40, sentenced to 46 months in prison.

Soto was sentenced by U.S. District Judge Marcia G. Cooke on January 23, 2008. Soto owned and operated Ocean Medical Equipment, Adriana Medical Supply, Advance Medical Equipment, Family Health Medical Equipment, First AA Medical, KB Medical Services, Rossmary Medical Supplies, R&R Medical Equipment, Sagua Medical Supplies, Telimay Medical Service, West Side Medical, Future Medical Center, Siboney Medical Center, and Tampa Trauma that billed for items such as oxygen concentrators, nebulizers and wheelchairs that were never provided. Soto submitted claims to Medicare for unnecessary medical equipment and he caused the submission of false claims for pharmaceuticals. In total, Soto, through his companies, was responsible for over $47 million in false claims to Medicare. Soto pleaded guilty on October 16, 2007.

Rodriguez was sentenced by U.S. District Judge James Lawrence King on January 16, 2008. Rodriguez owned and operated OxyCare of Miami, a fraudulent DME company that had nothing to do with providing health care or necessary medical equipment. Between September of 2001 and June of 2003, OxyCare submitted claims to Medicare for medical equipment largely consisting of unnecessary oxygen concentrators, hospital beds and pressure reducing mattresses. Further, Rodriguez caused the submission of false claims for pharmaceuticals. In total, Rodriguez, through his companies, was responsible for over $1.2 million in false claims to Medicare. Rodriguez pleaded guilty on October 10, 2007.

Gonzalez, the owner and operator of Genesis Associates Group, Inc., was sentenced by U.S. District Judge Donald L. Graham on January 10, 2008. Genesis was a fraudulent DME company that had nothing to do with providing health care or necessary medical equipment. Gonzalez submitted over $1.5 million in false claims to Medicare largely consisting of unnecessary power pressure reducing mattresses and orthotics. Gonzalez pleaded guilty on November 2, 2007.

Vasquez, the named owner of Tamiami Medical Supply, Inc., was sentenced by U.S. District Judge Joan A. Lenard on January 16, 2008. Tamiami was a fraudulent DME company that had nothing to do with providing health care or necessary medical equipment. Tamiami submitted over $1.2 million in false claims to Medicare. The previous named owner of Tamiami, Justo Padron, 36, died in November of 2007 after an alligator attack at the Miccosukee Tribe Indian Reservation. Vasquez pleaded guilty on October 22, 2007.

De La Serna was sentenced by U.S. District Marcia G. Cooke on January 23, 2008. De La Serna owned and operated Respiratory One Equipment, Inc., a fraudulent DME company that had nothing to do with providing health care or necessary medical equipment. Between September of 2001 and June of 2003, Respiratory One submitted claims to Medicare for medical equipment largely consisting of unnecessary oxygen concentrators and nebulizers. Further, De La Serna caused the submission of false claims for pharmaceuticals. In total, De La Serna was responsible for over $345,000 in false claim to Medicare. De La Serna pleaded guilty on November 15, 2007.

Betancourt, the named owner of Lincoln Medical Supply, was sentenced by U.S. District Judge James Lawrence King on January 16, 2008. Lincoln Medical was a fraudulent DME company that had nothing to do with providing health care or necessary medical equipment. Lincoln Medical submitted over $480,000 in false claims to Medicare for largely unnecessary equipment such as wound therapy pumps and expensive wound care items. Betancourt pleaded guilty on November 15, 2007.

Prieto and Herrera were sentenced by U.S. District Judge Jose A. Gonzalez for their involvement on January 18, 2008. Prieto and Herrera were owners and operators of Coral Way Medical, a fraudulent HIV infusion clinic that also billed for unnecessary procedures such as paravertebral joint injections. Prieto and Herrera used these two companies to submit over $900,000 in fraudulent Medicare claims. Prieto pleaded guilty on November 15, 2007. Herrera pleaded guilty on November 1, 2007.

Lopez, the owner and operator of Reny Medical Equipment, was sentenced by U.S. District Judge Marcia G. Cooke on January 23, 2008. Reny Medical was a fraudulent DME company that had nothing to do with providing health care or necessary medical equipment. Lopez submitted over $450,000 in false claims to Medicare for unnecessary items such as prosthetics and ostomy supplies. Lopez pleaded guilty on November 7, 2007.

"The Department of Justice places a high priority on investigating and prosecuting those who steal tax payer money intended to provide health care for the elderly and disabled," said Assistant Attorney General Fisher. "We have dedicated a team of experienced prosecutors to focus on Medicare and other healthcare fraud around the country."

"The fight against Health Care fraud in Miami is a top priority," said U.S. Attorney Acosta. "With the help of the newly formed HHS-OIG Florida Region which will add federal agents to our efforts we expect to see a significant impact on reducing fraud."

According to data from the Centers for Medicare and Medicaid Services (CMS), Miami-Dade County alone accounted for more paid DME claims than 44 other states. Only some of the most populous states in the country including California, Texas, New York, Michigan, and Ohio billed Medicare for more than Miami-Dade County. According to that same data, an average Medicare patient in Miami-Dade County allegedly receives $6,200 worth of DME every year based on paid amounts; whereas patients throughout the rest of the United States average approximately $1,200 per year.

The Soto and De La Serna cases were prosecuted by Deputy Chief Kirk Ogrosky from the Criminal Division's Fraud Section in Washington, D.C., and Assistant U.S. Attorney Ryan Stumphauser of the Southern District of Florida. The Vasquez and Betancourt cases were prosecuted by Assistant U.S. Attorney Stumphauser. The Rodriguez case was prosecuted by Deputy Chief Ogrosky, and Assistant U.S. Attorney Randy Katz. The Gonzalez case was prosecuted by Trial Attorney John S. Darden of the Fraud Section, the Prieto and Herrera cases were prosecuted by Trial Attorney Jerrob Duffy and Deputy Chief Ogrosky of the Fraud Section; and the Lopez case was prosecuted by Trial Attorney John Cunningham of the Fraud Section.

All cases were done with the investigative assistance of the U.S. Department of Health and Human Services Office of Inspector General and the FBI. The cases were each brought as part of the Medicare Fraud Strike Force, supervised by the Fraud Section of the Criminal Division and U.S. Attorney Acosta of the Southern District of Florida.


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SOURCE U.S. Department of Justice
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