Press Release
TWO SUSPECTS ARRESTED IN $21 MILLION MEDICARE ADVANTAGE FRAUD SCHEME SPANNING FIVE STATES
May 11, 2009
FOR IMMEDIATE RELEASE
R. Alexander Acosta, United States Attorney for the Southern District of Florida, Jonathan I. Solomon, Special Agent in Charge, Federal Bureau of Investigation, Miami Field Office, Daniel W. Auer, Special Agent in Charge, Internal Revenue Service, Criminal Investigation Division, and Al Lamberti, Sheriff, Broward County Sheriff's Office, announced that defendants Michel De Jesus Huarte and Ramon Fonseca, both of Miami, FL, were arrested today on a criminal complaint charging them with conspiracy to commit health care fraud, health care fraud, and conspiracy to commit money laundering. If convicted, each defendant faces a statutory maximum penalty of 10 years in prison on the health care fraud charges, and 20 years in prison on the money laundering charges.
According to the complaint affidavit, Huarte and Gonzalez operated and controlled nineteen (19) medical clinics purportedly operating in Florida, Georgia, Louisiana, North Carolina, and South Carolina. These companies collectively submitted at least $22.7 million in claims to various private insurance companies that offered coverage to Medicare beneficiaries through Medicare Advantage programs. A substantial portion of the billings were for expensive cancer and HIV medications that are often administered via infusion treatments, i.e., intravenously by use of a needle.
According to the complaint, two of the medical clinics, Fast Cure Company and Best Cure Company LLC, both allegedly operating in the New Orleans area, were empty store fronts with handwritten business signs. Investigation further revealed that two additional companies, Ziallet Services, Inc. and Magestic Group Service Inc., were merely post office boxes in North Carlina and South Carolina, respectively, with no real business activity. In addition, numerous Medicare Advantage beneficiaries that allegedly received medical treatment at Ziallet and Magestic confirmed that they never heard of Ziallet or Magestic, and never received any medical treatment at those locations.
The complaint affidavit further alleged that Huarte and Fonseca deposited fraud proceeds from their respective clinics at two Miami-area check cashing stores. The owners of the check cashing stores would wait for the checks to clear, and then deliver the resulting cash to Huarte and/or Fonseca. The typical cash deliveries were between $30,000 and $80,000, and occurred multiple times per week.
Mr. Acosta commended the investigative efforts of the Federal Bureau of Investigation, the Internal Revenue Service, and the Broward County Sheriff's Office. This case is being prosecuted by Assistant U.S. Attorney Ryan Stumphauzer.
A copy of this press release may be found on the website of the United States Attorney's Office for the Southern District of Florida at http://www.usdoj.gov/usao/fls. Related court documents and information may be found on the website of the District Court for the Southern District of Florida at http://www.flsd.uscourts.gov or on http://pacer.flsd.uscourts.gov.
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