A doctor licensed in Puerto Rico practicing medicine in Miami was recently arrested on 16 federal charges related to an alleged $20 million health care fraud scheme that reportedly involved claims to Medicaid and Medicare that were either fraudulent or false. Federal authorities also say the doctor was illegally distributing oxycodone and a number of other powerful controlled substances.
Federal prosecutors with the U.S. Justice Department allege the 51-year-old defendant attempted to defraud the government and receive health care bribes and kickbacks. Specifically, he owned an operated several clinics in Miami that “purported to practice medicine as an area of critical need.” According to the indictment, defendant from 2009 through this year referred Medicaid and Medicare recipients allegedly under his care to a local discount pharmacy as well as several home health agencies. In exchange, prosecutors allege, defendant received kickbacks and illegal bribes from these entities.
Further, authorities allege the doctor submitted claims to Medicare Part D for services like office visits and procedures that he either didn’t provide or that clearly weren’t medically necessary. Some of those included billing for removing lesions and therapeutic injections he never actually gave, authorities said. Prosecutors assert that in some cases, he wrote prescriptions to powerful drugs known to be cause addiction (i.e., oxycodone, hydrocodone, alprazolam and others) even though there was no valid medical reason to do so. Continue reading