Mother And Two Daughters Get Prison Terms For Medicare Fraud

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Main Category: Medicare / Medicaid / SCHIP
Also Included In: Litigation / Medical Malpractice
Article Date: 30 Jun 2008 - 1:00 PDT

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A mother and two daughters, owners of four healthcare corporations based in Miami were sentenced and remanded to prison for their part in plans to defraud the Medicare program, Matthew Friedrich, Acting Assistant Attorney General, Criminal Division, and R. Alexander Acosta, U.S. Attorney, Southern District of Florida announced last Friday.

The Department of Justice informed that the three women collected over $14 million from the Medicare program in unnecessary medicine, durable medical equipment and home health care services through their companies.

U.S. District Judge Cecilia M. Altonaga sentenced..

..Marta F. Jimenez (mother), 67, to 31 months in prison
..Maria T. Hernandez (daughter of Jimenez) 50, to 51 months in prison
..Maivi Rodriguez (daughter of Jimenez), 34, to 51 months in prison

They were all remanded into federal custody after sentencing was given.

The trial lasted one week. The jury convicted the three defendants on all charged accounts of:

-- conspiracy to defraud the U.S. government
-- causing the submission of false claims to Medicare
-- soliciting and receiving kickbacks
-- conspiracy to commit health care fraud

All three were also found guilty of multiple counts of receiving kickbacks in exchange for referring Medicare patients.

According to witnesses, Hernandez, Jimenez and Rodriguez controlled more than 60 Medicare beneficiaries for the sole purpose of swindling Medicare through their businesses.

Hernandez owned Action Best Medical Supplies Inc., a DME company. Jimenez and Rodriguez owned Esmar Medical Equipment Inc., a DME company; A & A Medical Services Inc., a home health care company; and M & M Comprehensive Inc., an assisted living facility.

According to patients, they were paid cash kickbacks for the use of their Medicare cards. Many of these patients lived in the assisted-living facility that Jimenez and Rodriguez owned.

Patients also testified that they "knowingly took cash kickbacks, were falsely diagnosed with chronic obstructive pulmonary disease and prescribed unnecessary aerosol medications, including commercially unavailable compounds." Compounding is a process in which the pharmacist mixes the medication at the pharmacy, rather than buying it from a pharmaceutical manufacturer.

According to trial testimony, one of the people making the medicine had no training or experience in manufacturing medicine - he was an auto-mechanic.

Source:
Department of Justice

Written by Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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