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Friday, October 17, 2008
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Jury Convicts Miami Physician and Nurse of $11 Million HIV Infusion Medicare Fraud

WASHINGTON – Miami physician Ana Alvarez-Jacinto, 54, and nurse Sandra Mateos, 43, were found guilty by a Miami jury today for their roles in an $11 million HIV/AIDS infusion fraud scheme, Acting Assistant Attorney General of the Criminal Division Matthew Friedrich announced.

After a two week trial in Miami, Alvarez-Jacinto was convicted of one count of conspiracy to defraud the United States, to submit false claims and to pay healthcare kickbacks; one count of conspiracy to commit health care fraud; and three counts of the submission of false claims to the Medicare program. Mateos was convicted of the two conspiracy counts.

Evidence at trial established that both defendants worked at Saint Jude Rehab Center Inc. (St. Jude), a clinic that purported to specialize in treating HIV/AIDS patients. St. Jude was operated and owned by indicted fugitives Carlos Benitez and Luis Benitez, and managed by convicted co-conspirators Aisa Perera and Mariela Rodriguez.

Evidence at trial proved that between June and November 2003, Alvarez-Jacinto, with the assistance Mateos, ordered hundreds of medically unnecessary HIV infusion treatments at the clinic. Evidence at trial also established that HIV-positive Medicare patients were brought to the clinic by Carlos and Luis Benitez for the purpose of getting cash payments in exchange for allowing the clinic to bill for unnecessary treatments. Testimony at trial revealed that defendant Mateos and other co-conspirators paid the patients cash kickbacks of approximately $150 per visit. After patients had been paid, they agreed to allow Alvarez-Jacinto and her co-conspirators to prescribe, and sometimes administer, unnecessary infusion treatments. According to testimony at trial, St. Jude then billed Medicare for approximately $11 million for the unnecessary services. For those claims, Medicare paid more than $8 million to St. Jude.

Perera and Rodriguez were previously charged in federal district court in Miami with conspiracy to defraud the United States, to cause the submission of false claims, to pay health care kickbacks and conspiracy to commit health care fraud. In addition, Rodriguez and Perera also were charged with four counts of submitting false claims to the Medicare program. On July 10, 2008, Perera was sentenced to 30 months in prison for her crimes. Rodriguez is awaiting sentencing.

Fugitives Carlos Benitez, Luis Benitez and Jose Benitez were indicted on June 11, 2008, for their role in an HIV infusion and money laundering scheme that exceeded $100 million for claims submitted by St. Jude and other clinics. The indictment alleges that Carlos, Luis and Jose Benitez were the masterminds of a large scale HIV infusion fraud operation throughout South Florida, involving at least 11 clinics, including St. Jude, and that they laundered the proceeds of their crimes. All three Benitez brothers remain at large.

This case was prosecuted by Senior Trial Attorney Charles E. Duross and Trial Attorneys John K. Neal and Laura Perkins of the Criminal Division’s Fraud Section, and was investigated by the FBI and the Department of Health and Human Services, Office of the Inspector General.

The case was brought by the Medicare Fraud Strike Force (MFSF). The MFSF is a multi-agency team of federal, state and local prosecutors and agents designed to combat Medicare fraud. Strike force operations began in the Miami area on March 1, 2007. The MFSF is led by Deputy Chief Kirk Ogrosky of the Criminal Division’s Fraud Section in Washington, D.C., and the office of U.S. Attorney R. Alexander Acosta of the Southern District of Florida. Since the inception of MFSF operations in 2007, federal prosecutors have indicted 104 cases with 184 defendants in both Los Angeles and Miami. Collectively, these defendants fraudulently billed the Medicare program for more than half a billion dollars.