Doctor Convicted of Nearly $2M Medicare and Medicaid Fraud Scheme

A federal jury convicted a Nevada doctor yesterday for his role in defrauding Medicare and Medicaid of nearly $2 million.

According to court documents and evidence presented at trial, Eduardo Abellana, M.D., 75, of Las Vegas, referred medically unnecessary prescriptions to City Drugs, a Detroit, Michigan, pharmacy, for patients he had not treated in exchange for cash kickbacks paid by the owners of the pharmacy. Abellana and his co-conspirators caused nearly $2 million of loss to Medicare and Medicaid.

The jury convicted Abellana of conspiracy to commit health care fraud and conspiracy to defraud the United States and receive kickbacks. He is scheduled to be sentenced on Sept. 25, and faces a maximum penalty of 10 years in prison on the conspiracy to commit health care fraud count and five years in prison on the conspiracy to defraud the United States and receive kickbacks count. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.

Principal Deputy Assistant Attorney General Nicole M. Argentieri, head of the Justice Department’s Criminal Division; Special Agent in Charge Cheyvoryea Gibson of the FBI Detroit Field Office; and Special Agent in Charge Mario M. Pinto of the Department of Health and Human Services Office of Inspector General (HHS-OIG) Chicago Region made the announcement.

The FBI Detroit Field Office and HHS-OIG investigated the case.

Trial Attorneys Claire Sobczak and Kelly M. Warner of the Criminal Division’s Fraud Section are prosecuting the case.

The Fraud Section leads the Criminal Division’s efforts to combat health care fraud through the Health Care Fraud Strike Force Program. Since March 2007, this program, currently comprised of nine strike forces operating in 27 federal districts, has charged more than 5,400 defendants who collectively have billed federal health care programs and private insurers more than $27 billion. In addition, the Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, are taking steps to hold providers accountable for their involvement in health care fraud schemes. More information can be found at www.justice.gov/criminal-fraud/health-care-fraud-unit.