Doctor Guilty of Health Care Fraud, Oxycodone Trafficking Scheme
APR 11 – (Miami, FL) - Mark R. Trouville, Special Agent in Charge, Drug Enforcement Administration (DEA), Wifredo A. Ferrer, United States Attorney for the Southern District of Florida, Christopher B. Dennis, Special Agent in Charge, Health and Human Services, Office of Inspector General (HHS-OIG), José A. Gonzalez, IRS Special Agent in Charge, Director James K. Loftus, Miami-Dade Police Department, Al Lamberti, Sheriff, Broward Sheriff’s Office, and H. Frank Farmer, M.D., State Surgeon General, Florida Department of Health (DOH), announced that, after a five day trial, a Miami federal jury found Frank J. Ballesteros, M.D., of Miami, guilty of conspiracy to possess with intent to distribute oxycodone and oxymorphone, possession of oxycodone and oxymorphone with intent to distribute those drugs, and conspiracy to commit health care fraud.
Sentencing has been scheduled for July 20, 2012, before U.S. District Judge Robert N. Scola, Jr. Ballesteros faces a maximum term of imprisonment of 20 years for each of his drug-trafficking offenses and a maximum of term of imprisonment of 10 years for his health care fraud offense.
Ballesteros was one of 24 defendants charged in a federal indictment on September 30, 2011. The indictment charged all of the defendants with participation in the drug-trafficking and health care fraud conspiracies. Certain of the defendants, including Ballesteros, were charged with having possessed with the intent to distribute oxycodone and oxymorphone. To date, 21 of the 24 defendants have pled guilty to the charges in the indictment and are awaiting sentencing. Six defendants, who agreed to cooperate with the United States, testified at the trial of Dr. Ballesteros.
According to the trial testimony of cooperating defendants Juan de Dios Gomez and Gerardo Gomez, in June 2009, they devised a scheme to obtain oxycodone for subsequent street sale using phony patients who would obtain unnecessary prescriptions. Under the Gomez brothers’ plan, co-defendants would recruit patients to visit the Gomez clinic, where they would see Dr. Ballesteros, who would write prescriptions for oxycodone, regardless of medical necessity. After the prescriptions were filled, the patients would sell their oxycodone back to the Gomez brothers. Under the scheme, the patients needed to have Medicare Part D prescription drug insurance to cover the cost of the drugs.
More specifically, the evidence at trial showed that from September 2009 until his arrest on October 12, 2011, Ballesteros worked at a series of offices in Miami and Hialeah. The offices were described as “fly-by-night” operations that would close and reopen at various strip malls. In actuality, Ballesteros did not see real patients, but only individuals who had been recruited by the Gomez brothers to participate in the oxy scheme. Ballesteros wrote the same prescriptions for each purported patient, regardless of medical necessity. According to the evidence, the recruiters and drivers would then transport the purported patients from Ballesteros’ office to the Robert’s Drug Store pharmacies in Miami, where the prescriptions would be filled. The patients would then return the oxycodone and oxymorphone to the recruiters/drivers.
At trial, the United States presented Medicare data showing that during the course of the drug-trafficking and health care fraud conspiracies, Ballesteros wrote approximately 6,667 fraudulent prescriptions for oxycodone and oxymorphone, at an estimated cost to taxpayers of $2.2 million. These prescriptions drugs were then diverted to the Gomez organization for sale in Florida, Kentucky, and Massachusetts.Mr. Ferrer commended the DEA, the HHS-OIG, the IRS, the Miami-Dade Police Department, the Broward Sheriff’s Office, and the Florida Department of Health, for their work on Operation Gotham. This case is being prosecuted by Assistant U.S. Attorneys Dwayne E. Williams and Yvonne Rodriguez-Shack.