The fraud files: Provider pleads guilty in $123 million scheme

Sunday, August 23, 2009

MIAMI - A Miami man pled guilty last week to submitting $123 million in fraudulent claims to Medicare for DME that had never been prescribed by physicians or delivered to beneficiaries.

Reinaldo Guerra owned and operated 11 DME companies, but he disguised his control using "straw" or nominee owners, according to a news release from the acting U.S. attorney for the Southern District of Florida.

Of the $123 million in submitted claims, Guerra's companies pocketed about $35 million, according to the release.

Guerra pled guilty to one count of conspiracy to commit Medicare fraud and one count of Medicare fraud. A Nov. 13 sentencing has been scheduled.

Additionally, Guerra's business partner, Jose Luis Perez, has been charged with submitting an additional $56 million in fraudulent claims to Medicare for unnecessary DME and pocketing $21 million, according to the Miami Herald.

Perez is a fugitive believed to be in Latin America, according to the newspaper.