WASHINGTON – The owner and operator of a Florida pharmacy and Durable Medicare Equipment (DME) company has been sentenced to 151 months in prison for Medicare fraud, 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.
Nelson Valdes was sentenced yesterday by U.S. District Judge Cecilia M. Altonaga in Miami. Judge Altonaga also ordered Valdes to pay almost $3.5 million in restitution for the money he received in false claims. A federal jury in Miami convicted Valdes of conspiring to defraud Medicare, taking kickbacks and other related charges, after a five-day trial in July 2007. The guilty verdict represented the third time Valdes had been convicted of Medicare fraud.
Valdes owned Florida Pharmacy and Discount and F & M Medical Rentals Inc. from March of 2000 to July 2007. In September of 2001, Valdes conspired with the owners of Med-Pro Billing and Unimed Pharmacy to refer paid patients in exchange for half of what Medicare paid for “compounded” aerosols. Compounding refers to the process of a pharmacist making medication as opposed to a pharmaceutical manufacturer.
After Unimed Pharmacy was shut down in 2003 by the FBI, Valdes obtained a pharmacy license through the assistance of Benjamin Metsch, an attorney convicted of Medicare fraud in 2006, and continued to compound medication for his paid patients. From 2001 to 2003, Unimed collected $7 million for aerosols, and from 2000 to 2007, Valdes' pharmacy and DME company collected in excess of $3 million for aerosols and equipment.
The compounding aerosol scheme was one of the most common health care frauds in south Florida. In 2006, the Medicare program paid for over $155 million worth of aerosol medications in Miami-Dade County, making it the single most common item billed to Medicare Part B. From 2005 to 2006, claims for these aerosol medications increased over 100 percent. In addition, according to Medicare data, Miami-Dade County alone accounted for more paid DME claims than every state in the country except California, Texas, New York, Michigan and Ohio.
The case was prosecuted by Deputy Chief Kirk Ogrosky and Trial Attorney John S. Darden from the Fraud Section of the Criminal Division, with the investigative assistance of the U.S. Department of Health and Human Services, Office of the Inspector General, the FBI, and the Medicaid Fraud Control Unit of the Florida Attorney General’s Office.
Since beginning operations in March of 2007, the strike force teams have indicted approximately 80 cases and 120 defendants in Miami-Dade County alone. The strike force teams are led by a federal prosecutor supervised by both the Criminal Division’s Fraud Section in Washington and the U.S. Attorney’s Office of the Southern District of Florida.