Two Miami Men Indicted for $179 Million Medicare Fraud Scheme
Crime Blotter
July 02, 2009
Jeffrey H. Sloman, Acting United States Attorney for the Southern District of Florida, Jonathan I. Solomon, Special Agent in Charge, Federal Bureau of Investigation, Miami Field Office, and Christopher B. Dennis, Special Agent in Charge, U.S. Department of Health and Human Services, Office of Inspector General, Miami Regional Office, announced that defendants Jose Luis Perez, of Golden Beach, FL, and Reinaldo Guerra, of Miami, FL, were indicted on June 30, 2009 on charges of conspiracy to commit Medicare fraud, Medicare fraud, and aggravated identity theft.
According to the Indictment unsealed today, the fraud involved durable medical equipment (DME), which is equipment that can be used in the home on a repeated basis for a medical purpose. Where DME is prescribed or ordered by a physician, an authorized Medicare provider who supplies the equipment to a Medicare beneficiary may be eligible for reimbursement by Medicare.
The Indictment charges that Perez and Guerra owned and operated 21 corporations that purported to supply DME to Medicare beneficiaries pursuant to physicians´ prescriptions or written orders, using straw or nominee owners to disguise their control over the companies. They submitted approximately $179 million in fraudulent claims to Medicare for DME that had not been prescribed or ordered by a physician nor delivered to a Medicare beneficiary. Based on those claims, Medicare paid the DME companies approximately $56 million. In addition to health care fraud, the defendants were charged with aggravated identity theft for using physicians´ Medicare identification numbers without the physicians´ authorization.
Guerra has been arrested and appeared in court earlier today. Perez remains at large and is being sought by law enforcement.
Mr. Sloman commended the investigative efforts of the Federal Bureau of Investigation and the U.S. Department of Health and Human Services, Office of Inspector General. This case is being prosecuted by Assistant U.S. Attorney Marc Osborne.
A copy of this press release may be found on the website of the United States Attorney's Office for the Southern District of Florida at www.usdoj.gov/usao/fls. Related court documents and information may be found on the website of the District Court for the Southern District of Florida at www.flsd.uscourts.gov or on http://pacer.flsd.uscourts.gov.
According to the Indictment unsealed today, the fraud involved durable medical equipment (DME), which is equipment that can be used in the home on a repeated basis for a medical purpose. Where DME is prescribed or ordered by a physician, an authorized Medicare provider who supplies the equipment to a Medicare beneficiary may be eligible for reimbursement by Medicare.
The Indictment charges that Perez and Guerra owned and operated 21 corporations that purported to supply DME to Medicare beneficiaries pursuant to physicians´ prescriptions or written orders, using straw or nominee owners to disguise their control over the companies. They submitted approximately $179 million in fraudulent claims to Medicare for DME that had not been prescribed or ordered by a physician nor delivered to a Medicare beneficiary. Based on those claims, Medicare paid the DME companies approximately $56 million. In addition to health care fraud, the defendants were charged with aggravated identity theft for using physicians´ Medicare identification numbers without the physicians´ authorization.
Guerra has been arrested and appeared in court earlier today. Perez remains at large and is being sought by law enforcement.
Mr. Sloman commended the investigative efforts of the Federal Bureau of Investigation and the U.S. Department of Health and Human Services, Office of Inspector General. This case is being prosecuted by Assistant U.S. Attorney Marc Osborne.
A copy of this press release may be found on the website of the United States Attorney's Office for the Southern District of Florida at www.usdoj.gov/usao/fls. Related court documents and information may be found on the website of the District Court for the Southern District of Florida at www.flsd.uscourts.gov or on http://pacer.flsd.uscourts.gov.