Family Crime Ring Sentenced in S. Fla. Kickback Scheme

TAMPA, Fla.–Four family members who owned a series of Miami DME
companies and outpatient rehab facilities have each been sentenced
to 57 months in prison for Medicare fraud, Assistant Attorney
General Alice S. Fisher of the Criminal Division and U.S. Attorney
R. Alexander Acosta of the Southern District of Florida announced
Nov. 9.

Carlos Berenguer, 61, Ivan Aguera, 34, Aristides Berenguer, 64,
and Robert Berenguer, 58, were sentenced for their roles in a $20
million Medicare kickback and medication billing scheme, according
to the U.S. Attorney’s office. In addition to their prison terms,
each was ordered to pay over $1.4 million in restitution.

The four defendants pleaded guilty to 14 criminal counts in
March.

Brothers Carlos and Aristides Berenguer owned Select Medical
Equipment, while another brother, Robert Berenguer, owned
Professional Medical Equipment. Carlos Berenguer’s stepson, Ivan
Aguera, owned Palm Medical Equipment. Through these companies, the
four recruited and paid Medicare patients to participate in schemes
involving false claims for unnecessary oxygen concentrators and
compounded aerosol medications.

Prosecutors said none of the four defendants owned a pharmacy
capable of billing Medicare for drugs, so they conspired with the
owners of Miami pharmacies to refer patients in exchange for half
of what Medicare paid for aerosol drugs. From 2001 to 2003, the
Berenguers and Aguera were responsible for Medicare’s payment of
over $1.4 million based on false claims.

Another family member, Ricardo Aguera, who owned three Miami
health care companies, was sentenced to 121 months in prison
following a week-long jury trial in March.

According to the U.S. Attorney’s office, the aerosol medication
scheme was one of the most common health care frauds in south
Florida. In 2006, Medicare paid over $155 million for aerosol meds
in Miami-Dade County, making it the single most common item billed
to Part B. From 2005 to 2006, claims for aerosol medications
increased over 100 percent. In addition, according to Medicare
data, Miami-Dade County alone accounted for more paid DME claims
than every state in the country except California, Texas, New York,
Michigan and Ohio.

Kirk Ogrosky, deputy chief of the fraud section of the U.S.
Attorney’s criminal division, Miami, and Jeffrey Neiman, trial
attorney with the fraud section of the Department of Justice,
Washington, prosecuted the case with assistance from the HHS Office
of Inspector General, the FBI and the Medicaid Fraud Control Unit
of the Florida Attorney General’s Office.

In related news, another south Florida DME provider was
sentenced to more than five years in prison for her role in a
compounded aerosol medications scheme.

Marianela Smith was sentenced to a 66-month prison term and
ordered to pay $363,000 in restitution by the U.S District Court
for the Southern District of Florida Nov. 9. Smith, who was tried
in August, was found guilty of five criminal counts involving
physician kickbacks for phony prescriptions for the compounded
meds. According to a statement from the U.S. Attorney’s office, she
obtained the aerosol medications from previously convicted pharmacy
owners in Miami. Between 2000 and 2003, those pharmacies billed
Medicare more than $17 million.

Since beginning operations in March, Medicare Fraud Strike Force
teams in South Florida have indicted 120 defendants in Miami-Dade
County alone.
Read more about the Strike Force, click here.

To read more about the case against Marianela Smith, see

HomeCare Monday, Sept. 10.