Tag: Medicare fraud

MIAMI – A south Florida federal grand jury has charged Mirosis Gonzalez and her daughter Berioska Sosa with paying kickbacks in exchange for referrals of Medicare beneficiaries to their pharmacy, then using the referrals to steal millions from Medicare. Gonzalez and Sosa owned and operated Aviva Care Pharmacy (which did business under the name American Care Pharmacy) in Sunrise, Fla. From August 2016 through May 2020, the defendants allegedly paid kickbacks and bribes to marketing and telemedicine...

MIAMI - Ariel Madero Paez, 56, has pleaded guilty in federal court in Ft. Pierce to fraudulently billing Medicare over $2 million for durable medical equipment that was never provided to beneficiaries. According to court records, from November 2021 through May 2022, Always submitted approximately $2.2 million in fraudulent health care claims to Medicare for DME that Always never provided, and that Medicare beneficiaries never requested. As a result, Medicare paid over $1.4 million. After Madero’s...

WASHINGTON – The national Health Care Fraud and Abuse Control program is marking 25 years of operation and continued success in identifying and prosecuting the most egregious instances of health care fraud, preventing future fraud and abuse, and protecting program beneficiaries. During fiscal year 2021, the federal government won or negotiated more than $5 billion in health care fraud judgments and settlements, in addition to other health care administrative impositions. The program’s...

CHARLOTTE, N.C. – A Charlotte doctor is facing federal charges for her role in a DME scheme that defrauded federal benefits programs of more than $11 million, according to the Department of Justice, U.S. Attorney’s Office, Western District of North Carolina. Sudipta Mazumder, 46, is charged with one count of health care fraud and six counts of making false statements relating to health care matters. According to allegations contained in the indictment, during 2019 and 2020, Mazumder was...

MIAMI – A federal judge in Miami ordered that a Hialeah resident who allegedly submitted more than $4 million in fraudulent health care claims to Medicare be detained pending trial, after he was arrested on board a jet ski headed south from Key West toward Cuba. According to allegations in the criminal complaint, from February through April, 54-year-old Ernesto Cruz Graveran owned Xiko Enterprises, Inc., a Florida corporation that purported to provide DME to eligible Medicare beneficiaries....

WASHINGTON – A woman was arrested on June 1 in Hampton, Ga., on criminal charges related to her alleged scheme to defraud Medicare by prescribing medically unnecessary DME that was then billed to Medicare. Kateline Lavache, 53, allegedly prescribed medically unnecessary DME for Medicare beneficiaries in exchange for kickbacks and bribes from her co-conspirators, according to an indictment. She allegedly had no prior relationship with the beneficiaries, was not treating them and failed to conduct...

WASHINGTON – Ten Florida residents were charged in an indictment unsealed on Feb. 25 in the Southern District of Florida for their alleged roles in a $67 million scheme involving the submission of false and fraudulent claims to Medicare for medically unnecessary genetic tests and DME.  The indictment alleges that, between January 2020 and July 2021, the defendants referred Medicare beneficiaries for medically unnecessary genetic tests and DME. In exchange for doctors’ orders for...

NEWARK, N.J. – Two Florida men have been indicted for their roles in DME and compound medication schemes involving kickbacks and fraud, the Department of Justice and the U.S. Attorney’s Office for the District of New Jersey have announced. Thomas Farese of Delray Beach, Fla., and Domenic Gatto of Palm Beach Gardens, Fla., are charged in an 11-count indictment with conspiracy to commit wire fraud, conspiracy to commit health care fraud, conspiracy to transact in criminal proceeds, transacting...

WASHINGTON – The Department of Justice has announced criminal charges against 138 defendants for their alleged participation in various health care fraud schemes, including those involving telemedicine and DME, that have resulted in about $1.4 billion in alleged losses.  Of the total, 43 defendants have been charged for their participation in schemes involving telemedicine, resulting in $1.1 billion in alleged losses. Certain telemedicine execs allegedly paid doctors and nurse...

RALEIGH, N.C. – Shelly Phillips Bandy, co-owner of A Perfect Fit For You, a DME company based here, has been sentenced to 30 months in federal prison, followed by three years of supervised release on a charge of Making Material False Statements Relating to Healthcare Matters. In December, Bandy admitted to submitting fraudulent claims to Medicaid on behalf of A Perfect Fit.  Specifically, she admitted that on Jan. 1, 2016, she billed Medicaid for 43 fraudulent claims, totaling $626,773.79,...