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Owner of Medicare Billing Service Sentenced to 10 Years in Prison for Role in $170 Million Medicare Fraud Scheme

WASHINGTON – Miami resident Rita Campos Ramirez, 60, was sentenced to 10 years in prison for her role in a $170 million scheme to defraud Medicare, 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. The scheme represents the largest known individual case of Medicare fraud in the history of the program.

Campos was sentenced today in the U.S. District Court for the Southern District of Florida by Judge Alan S. Gold. In addition to the prison sentence, Judge Gold ordered that the defendant be placed on three years of supervised release following her release from prison; forfeit $207,000, her three homes and an automobile; and pay $105 million in restitution to the U.S. Department of Health and Human Services.

Campos pleaded guilty on Aug. 28, 2007, to one count of conspiracy to commit health care fraud and one count of submitting false claims to Medicare. As part of her plea, Campos admitted that between October 2002 and April 2006 she owned and operated R&I Medical Billing Inc., a medical billing company that specialized in submitting bills to the Medicare program on behalf of HIV infusion clinics. Campos admitted that she knowingly submitted approximately $170 million in fraudulent medical bills to Medicare on behalf of 75 HIV infusion clinics in Miami-Dade County that were part of the scheme. Infusion clinics serve HIV patients by providing prescribed medications intravenously.

The Medicare program paid approximately $105 million of the $170 million in fraudulent bills submitted by Campos, with Campos personally receiving $5 million for her role in the fraud.

“Stealing public dollars for personal enrichment is a criminal act that will not be tolerated by the public or the Department of Justice. Today’s sentencing proves that defendants who violate the law and defraud Medicare, a program that provides essential health services to those who need it most, will be punished,” said Assistant Attorney General Alice S. Fisher.

“The rampant billing fraud perpetrated by this defendant squandered millions of dollars in scarce Medicare resources.  The health care fraud epidemic in South Florida must stop, and the U.S. Attorney’s Office will continue to aggressively investigate and prosecute these cases.” said U.S. Attorney R. Alexander Acosta.

FBI Special Agent in Charge Jonathan I. Solomon said, “The sentence in this case dispels the myth that white collar crime defendants get off lightly. It reinforces the message that health care fraud - stealing from U.S. taxpayers - is a serious crime. The FBI will continue to combat health care fraud by helping put these criminals behind bars where they belong.”

The case was prosecuted by Trial Attorney Hank Bond Walther of the Criminal Division’s Fraud Section, with the investigative assistance of the FBI. The Campos case is part of broader investigations by the Medicare Fraud Strike Force into HIV infusion fraud in the south Florida area. The Strike Force is led by Deputy Chief Kirk Ogrosky of the Criminal Division’s Fraud Section and the office of U.S. Attorney R. Alexander Acosta of the Southern District of Florida.