Middletown Rheumatologist Admits Defrauding Medicaid Program
John H. Durham, United States Attorney for the District of Connecticut, announced that CRISPIN ABARIENTOS, M.D., 44, of Middletown, waived his right to be indicted and pleaded guilty today in Hartford federal court to one count of health care fraud.
According to court documents and statements made in court, Abarientos owns and operates Middlesex Rheumatology in Middletown. One of the medications that Abarientos prescribes to his Middlesex Rheumatology patients is Remicade, an injectable prescription medication used to treat rheumatoid arthritis. When treating Medicaid patients with Remicade, Abarientos was required to submit a claim to Connecticut Medicaid for Remicade on behalf of each member patient. Medicaid then sent payment to Caremark Massachusetts Specialty Pharmacy in Massachusetts, which delivered the quantity of Remicade contained in the claim directly to Middlesex Rheumatology for the Medicaid patient without any out-of-pocket cost to Abarientos.
Between September 2013 and January 2018, Abarientos and his medical practice submitted to Medicaid false claims for the delivery to Middlesex Rheumatology of Remicade that Abarientos represented was to be provided to his Medicaid patients, when he knew that those Medicaid patients were not being treated with Remicade. Through this scheme, Abarientos obtained approximately $894,789 of Remicade to which he was not entitled. Abarientos then proceeded to infuse the fraudulently obtained Remicade into Medicare patients or patients with commercial insurers, and submitted claims to those insurers for reimbursement, which he was able to keep as profit for himself.
Abarientos subsequently attempted to hide the scheme from investigators by submitting documents that had been falsified to make it appear as if the patients he utilized to obtain the Remicade from Medicaid were being treated with the medication when they were not.
Abarientos is scheduled to be sentenced by U.S. District Judge Vanessa L. Bryant on October 30, 2019, at which time he faces a maximum term of imprisonment of 10 years.
This matter is being investigated by Office of the Inspector General of the U.S. Department of Health and Human Services, the Federal Bureau of Investigation, the Medicaid Fraud Control Unit of the Chief State’s Attorney’s Office, and the Connecticut Office of the Attorney General. The case is being prosecuted by Assistant U.S. Attorney Lauren Clark.
People who suspect health care fraud are encouraged to report it by calling 1-800-HHS-TIPS or the Health Care Fraud Task Force at (203) 777-6311.