Officials Announce Crackdown on South Florida Health Care Fraud

TAMPA, Fla.–State and federal law enforcement officials
recently announced a joint effort to prosecute health care fraud
perpetrators in South Florida, calling the region one of the worst
for such crimes in the country.

“False billings, diversion of drugs and medical equipment, and
other types of health care fraud cost taxpayers millions of dollars
annually,” said R. Alexander Acosta, U.S. Attorney for the Southern
District of Florida. “More importantly, health care fraud endangers
the health and well-being of our patients.”

Acosta announced the new initiative with Florida Attorney
General Charlie Crist.

Since mid-June, the U.S. Attorney’s office has charged 64
defendants in 28 separate criminal cases totaling more than $20
million in losses for Medicare, Medicaid and other health insurance
programs, Acosta said. In addition, the office’s civil division has
obtained seven injunctions to freeze some $14 million in fraud
proceeds.

But law enforcement officials have painted an even grimmer
picture: Michael Clemens, FBI special agent in charge of the Miami
field office, estimated that in 2004 health care fraud losses in
southeastern Florida were $1 billion. And the FBI office in Miami
has 30 agents working health care fraud cases: 100 active
investigations representing $3 billion in losses.

“South Florida is ground zero for health care fraud,” Clemens
said at a news conference about the initiative.

With the new joint initiative, officials also announced recently
filed criminal charges against 20 health care fraud defendants in
12 separate cases, four involving durable medical equipment:

–Ahmed Pons, Santos Infante, Juan Carlos Olive, Diomar Ortega,
and Sergio Ortega are charged with a scheme to defraud Medicare
through the submission of false claims concerning Miami-area DME
companies;

–Antonio Hevia allegedly recruited and paid kickbacks to Medicare
patients for access to their patient identification information,
which several Miami DME companies then used to submit fraudulent
claims to Medicare;
–Miguel Ugarte, an orthotist, allegedly was paid to sign forms
indicating that he had fitted Medicare patients for specialized
orthotic equipment, for which Medicare was fraudulently billed by
various Miami DME companies; and
–Yolanda Lobo, a licensed physician, is charged with making false
statements to Medicare in certificates of medical necessity to
support the Medicare payment for power wheelchairs.

The Hevia and Ugarte cases are the latest prosecutions arising
from Operation Wash Rag, an investigation conducted by the FBI and
HHS-OIG, which has resulted in the conviction of 10 defendants who
have received prison sentences ranging from 18 to 99 months.

Acosta urged anyone with information regarding possible health
care fraud to contact HHS at their toll-free fraud hotline (800)
HHS-TIPS.