A Medical Device Daily
A federal jury in Miami, Florida has convicted dermatologist Ana Caos, MD, of Medicare fraud.
After a nine-day trial in Miami, the jury found Caos, 62, guilty 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.
Caos was originally convicted on March 7, but the court ordered a retrial based on issues that arose during Caos' prior testimony. Sentencing on this conviction has been scheduled for July 18. Caos faces a maximum of 15 years in prison.
At trial, the jury heard testimony from Caos' patients that she wrote prescriptions for medications that the patients did not want or need, solely for the purpose of billing Medicare for the medications. The patients testified that they were falsely diagnosed with chronic obstructive pulmonary disease (COPD) and therefore prescribed unnecessary compounded aerosol medications that they threw in the trash immediately upon receiving them.
An expert pulmonologist from the University of Miami Medical School testified that prescribing compounded aerosols for the treatment of COPD was unnecessary because there are numerous commercially available medications that can be prescribed. Compounding is the process of a pharmacist making medication as opposed to a pharmaceutical manufacturer.
As part of these conspiracies, Caos wrote unnecessary prescriptions for homemade compounded medicines for more than 40 patients. Between February 2001 and June 2003, Medicare was billed $620,000 by complicit pharmacies for unnecessary aerosol prescriptions; by complicit durable medical equipment companies for equipment used with those drugs; and for visits to Caos.
Another former physician, Pedro Cuni, currently serving time in prison for Medicare fraud, testified that Maria Hernandez, the owner of Action Best Medical Supplies (Miami), informed him that she was utilizing Caos to write false prescriptions. The jury also heard testimony from Orlando Pascual, another company owner who is serving time in prison for Medicare fraud, that he purchased prescriptions from Caos at $100 per prescription.
In 2006, the Medicare program paid for more than $155 million worth of aerosol medications in Miami-Dade County alone. These drugs were the single most common item billed to Medicare Part B and accounted for more than 32% of all equipment claims filed in Miami-Dade County. From 2005 to 2006, claims for aerosol medications rose more than 100% in Miami-Dade County.