Former Owner And Operator Of Purported HIV/AIDS Health Clinics Sentenced To 63 Months In Prison For $12 Million Medicare Fraud Scheme
Preet Bharara, the United States Attorney for the Southern District of New York, announced that JORGE JUVIER, a former owner and operator of multiple HIV/AIDS clinics in New York City, was sentenced today to 63 months in prison for engaging in a scheme to defraud Medicare out of more than $12 million through the use of fraudulent HIV/AIDS clinics in New York City. As part of the Medicare fraud scheme, JUVIER and his co-conspirators paid patients cash kickbacks for coming to the clinics, coached patients on lies to tell clinic doctors to enable fraudulent billing, and billed Medicare for medications that were never administered, that were administered at incorrect dosages, or that were medically unnecessary. JUVIER previously pled guilty to conspiring to commit health care fraud before U.S. Magistrate Judge Frank Maas. U.S. District Judge Kimba M. Wood imposed today’s sentence.
Manhattan U.S. Attorney Preet Bharara said: “Jorge Juvier and his co-conspirators set up and operated health care fraud mills and billed Medicare for HIV/AIDS medications that were incorrectly provided or not provided at all. Juvier and his co-conspirators effectively stole more than $12 million from U.S. taxpayers that could have been used to pay for legitimate Medicare expenses. The sentence imposed today on Juvier reflects the seriousness of his offense.”
According to the criminal complaint, the criminal information, and other documents filed in Manhattan federal court, as well as statements made at related court proceedings:
JUVIER and his co-conspirators set up and operated multiple health care clinics in New York City that purported to provide injection and infusion treatments to Medicare-eligible HIV/AIDS patients, but that were, in reality, health care fraud mills (the “Clinics”), that routinely billed Medicare for medications that were never provided or were provided at highly diluted doses, and that were often unnecessary because the person being “treated” did not medically need the treatments.
JUVIER and his co-conspirators executed the fraudulent scheme by recruiting HIV/AIDS patients who were eligible for Medicare to come to the Clinics multiple times per week, for multiple months, to undergo expensive “treatments” that were often unnecessary. The purported treatments included drugs costing hundreds of dollars each to administer, which were typically reserved for cancer and anemia patients. JUVIER and his co-conspirators paid the patients cash kickbacks of up to $300 per week in exchange for coming to the Clinics and agreeing to undergo the treatments. Patients were also offered approximately $50 for each additional patient they referred to the Clinics. JUVIER and his co-conspirators regularly instructed patients to lie to clinic doctors by claiming they had medical conditions that they did not in fact have. JUVIER and his co-conspirators then used these patients’ status as Medicare beneficiaries to submit claims to Medicare for reimbursement for the treatments purportedly administered to the patients, often receiving tens of thousands of dollars in reimbursements per patient. However, in truth, the treatments typically were provided in highly diluted doses or not provided at all, and were often medically unnecessary. As a result of the scheme, from 2009 through 2013, JUVIER and his co-conspirators defrauded the Medicare system out of at least $12 million.
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In addition to the term of prison, JUVIER, 58, of Queens, New York, was sentenced to three years of supervised release and was ordered to pay $12,233,292.23 in forfeiture and $12,233,292.23 in restitution.
Oscar Huachillo, 56, of Manhattan, was charged separately in connection with the above-described Medicare fraud scheme. On August 25, 2015, U.S. District Judge Katherine Polk Failla sentenced Huachillo to 87 months in prison, $31,177,987.84 in forfeiture, and $3,454,244.16 in restitution. To date, the United States has recovered over $14 million in assets through forfeiture as part of this prosecution.
Mr. Bharara praised the outstanding efforts of the Department of Health and Human Services-Office of the Inspector General, IRS-Criminal Investigation Division, and the Federal Bureau of Investigation in the investigation.
This case is being handled by the Office’s Complex Frauds and Cybercrime Unit. Assistant U.S. Attorney Jonathan Cohen is in charge of the prosecution.