A Medical Device Daily

The owners of four Miami-based healthcare companies were sentenced and remanded to prison last week for their roles in schemes to defraud the Medicare program, said Acting Assistant Attorney General Matthew Friedrich of the Criminal Division and U.S. Attorney R. Alexander Acosta of the Southern District of Florida.

Collectively, the three defendants through their companies collected more than $14 million from the Medicare program for unnecessary medicine, durable medical equipment (DME) and home healthcare services.

U.S. District Judge Cecilia Altonaga sentenced Maria Hernandez (Mayte) to 51 months in prison, Marta Jimenez to 31 months in prison and Maivi Rodriguez to 51 months in prison. All three were remanded into federal custody at the conclusion of the sentencing. Hernandez and Rodriguez are the daughters of Jimenez.

On March 7, after a five-week trial, a jury convicted Hernandez, Jimenez and Rodriguez on all charged counts, including conspiracy to defraud the U.S. government, to cause the submission of false claims to Medicare, and to solicit and receive kickbacks; and conspiracy to commit healthcare fraud.

Additionally, the defendants were found guilty of multiple counts of receiving kickbacks in exchange for referring Medicare patients.

At trial, the jury heard testimony that Hernandez, Jimenez and Rodriguez controlled more than 60 Medicare beneficiaries for the sole purpose of defrauding Medicare through the businesses they owned. Hernandez owned Action Best Medical Supplies, a DME company. Jimenez and Rodriguez owned Esmar Medical Equipment, a DME company; A & A Medical Services, a home health care company; and M & M Comprehensive, an assisted living facility.

Patients testified at trial that they were paid cash kickbacks in exchange for use of their Medicare cards. Several of the patients lived in the assisted living facility owned by Jimenez and Rodriguez.

Patients 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 refers to the process of a pharmacist mixing the medication in the pharmacy, instead of purchasing it from a pharmaceutical manufacturer.

Trial testimony revealed that one of the men making the medicine was trained as an auto mechanic without any education, training or experience manufacturing medicine. In total, the co-conspirator pharmacies associated with Hernandez, Jimenez and Rodriguez were paid more than $14 million between 2000 and 2003 based on the submission of claims for medically unnecessary aerosols.

The case was prosecuted by Deputy Chief Kirk Ogrosky and Senior Trial Attorney John S. Darden of the Criminal Division's Fraud Section in Washington, with the investigative assistance of the Department of Health and Human Services, Office of Inspector General and the FBI.