Medical Clinic Executives and Worker Plead Guilty to $5.3 Medicare Fraud Scheme
WASHINGTON – The owners and operators of two Miami medical clinics, along with a phlebotomist at one of the clinics, have pleaded guilty to defrauding the Medicare program in connection with a $5.3 million HIV and cancer infusion fraud scheme, Acting Assistant Attorney General Matthew Friedrich of the Criminal Division and U.S. Attorney R. Alexander Acosta of the Southern District of Florida announced today.
Juan A. "Tony" Marrero, 41, Belkis Marrero, 41, and Luz Borrego, 43, each pleaded guilty on Jan. 14, 2009, to conspiracy to commit healthcare fraud before U.S. District Judge Ursula Ungaro in the Southern District of Florida. In their pleas, Tony and Belkis Marrero admitted that they co-owned two Miami clinics named Medcore Group LLC (Medcore) and M&P Group of South Florida Inc. (M&P).
Medcore and M&P purported to specialize in the treatment of HIV-positive patients. The Marreros admitted that beginning in August 2004 and continuing through November 2006 they conspired with others to submit approximately $5.3 million in fraudulent claims to Medicare. Borrego acknowledged her role in the fraud at Medcore where she was a phlebotomist who administered unnecessary drugs intravenously to HIV patients. Tony Marrero also pleaded guilty to two separate conspiracies to launder the proceeds of the health care fraud. Sentencing for all three defendants is scheduled for April 3, 2009.
During their pleas, the defendants admitted that Medcore and M&P were operated for the purpose of defrauding Medicare and that the treatments for infused or injected drugs billed to Medicare were not medically necessary. Each of the defendants also admitted that all of the patients at the clinics were participants in the fraud. The defendants admitted that they, or their co-conspirators, entered into kickback arrangements with these Medicare beneficiaries whereby the beneficiaries were paid every week in exchange for their Medicare billing information, which allowed the clinics to submit the fraudulent bills.
To obtain all the cash necessary to pay the patients, Tony Marrero admitted that he and others would write checks that appeared legitimate to people who would cash the checks and then return the cash to them for a fee.
The defendants admitted that none of the Medicare beneficiaries needed the injection and infusion treatments billed to Medicare by the clinics. Tony and Belkis Marrero acknowledged that clinic employees intentionally manipulated patients’ blood samples so that they would appear to need treatment, when in fact they did not. Belkis Marrero and Borrego also admitted that they put together medical files to make them appear legitimate and that they supported the treatments being billed to Medicare.
On Jan. 7, 2009, Orlando Pascual Jr., a co-owner of Medcore and M&P, pleaded guilty to his role in the Medicare fraud and money laundering conspiracies. Pascual is currently incarcerated for Medicare fraud involving the operation of a separate durable medical equipment company that he operated from 2001 to 2003.
On Jan. 14, 2009, Harold Sio, the owner of pharmaceutical wholesale company named Lifecare Medical, was charged by criminal information with conspiracy to commit health care fraud and conspiracy to commit money laundering. Sio, whose company supplied Medcore and M&P with infusible drugs, allegedly conspired with Pascual and Tony Marrero to accomplish the health care fraud scheme by providing false invoices for the drugs allegedly used in the scheme.
Four co-defendants in the case are scheduled for trial beginning Feb. 9, 2009, in the Southern District of Florida. An indictment and an information are merely charges, and defendants are presumed innocent unless and until proven guilty beyond a reasonable doubt.
The case was prosecuted by Deputy Chief Kirk Ogrosky, Assistant Chief John S. (Jay) Darden, and Trial Attorney Charles Reed of the Criminal Division’s Fraud Section, and was investigated by the Department of Health and Human Services, Office of the Inspector General and the FBI. The case was brought as part of the Medicare Fraud Strike Force (MFSF), supervised by the Criminal Division’s Fraud Section and U.S. Attorney Acosta of the Southern District of Florida. Since the inception of MFSF operations, federal prosecutors have indicted 106 cases with 190 defendants in both Los Angeles and Miami. Collectively, these defendants fraudulently billed the Medicare program for more than half a billion dollars.