Doctor Indicted and Arrested For Health Care Fraud

SAN JUAN, Puerto Rico – On July 31, 2019, a Federal Grand Jury in the District of Puerto Rico returned an indictment charging Dr. Antonio REYES-VIZCARRONDO with one count of conspiracy to commit health care fraud and one count of health care fraud. The defendant was arrested today, announced U.S. Attorney Rosa Emilia Rodríguez-Vélez of the District of Puerto Rico. The Office of Inspector General for the United States Department of Health and Human Services (HHS-OIG) and the Federal Bureau of Investigation (FBI) are in charge of the investigation.

According to the indictment, from in or about 2008 to through in or about 2015, Dr. Antonio REYES-VIZCARRONDO enriched himself by submitting or causing to be submitted false and fraudulent claims to health care benefits programs, including Medicare and Medicaid.  The claims submitted by REYES-VIZCARRONDO were for services using procedural codes that he was aware he could not use pursuant to the contractual terms of his employment, services rendered that were, in fact, rendered by other physicians. Defendant concealed the submission of these false and fraudulent claims to health care benefit plans and the receipt and transfer of the resulting fraudulent proceeds, and diverted these fraudulently obtained proceeds for his personal use and benefit. 

Dr. REYES-VIZCARRONDO submitted and/or caused to be submitted to Medicare and Medicaid a total of 8,159 claims using prohibited medical codes, including prohibited codes for services not rendered, totaling $882,608.91. Dr. REYES-VIZCARRONDO is facing a health care fraud forfeiture allegation of $601,783.47, which constitutes the amount of money Medicare and Medicaid paid the defendant.

“The submission of false claims to health care benefit programs is unacceptable and a waste of taxpayer funds,” said U.S. Attorney Rosa E. Rodriguez- Vélez. “Today’s arrest shows the Department of Justice and its law enforcement partners’ firm commitment to protect public funds and to safeguard the well-being of Medicare and Medicaid beneficiaries.”

Pursuant to the charges, the defendant faces possible sentences of up to 10 years for the health care fraud and conspiracy to commit health care fraud. This case was investigated by HHS-OIG and the FBI, and is being prosecuted by Assistant U.S. Attorney Scott Anderson.

Indictments contain only charges and are not evidence of guilt.  The defendant is presumed innocent unless and until proven guilty.