Miami Resident Sentenced to 22-Year Prison Term for Medicare Fraud Scheme; Five Others Sentenced to Jail Terms

January 28, 2010 - Jeffrey H. Sloman, United States Attorney for the Southern District of Florida; John V. Gillies, Special Agent in Charge, Federal Bureau of Investigation, Miami Field Office; Daniel W. Auer, Special Agent in Charge, Internal Revenue Service, Criminal Investigation Division; Al Lamberti, Sheriff, Broward Sheriff’s Office; and Amos Rojas, Jr., Special Agent in Charge, Florida Department of Law Enforcement, announced that defendants Michel De Jesus Huarte, Alyd Dazza, Ricco Dazza, Monika Blacio, Dayron Porrata, and Wally Proenza, all residents of Miami-Dade County, were sentenced today by the Honorable Patricia Seitz for various offenses including conspiracy to commit Medicare fraud, conspiracy to commit money laundering, and aggravated identity theft. One remaining defendant, Vicente Gonzalez, will be sentenced on February 1, 2010.

The lead defendant, Michel De Jesus Huarte, was sentenced to 264 months' incarceration while co-defendant Alyd Dazza was sentenced to 179 months' imprisonment, co-defendant Ricco Dazza was sentenced to 115 months' imprisonment, co-defendant Monika Blacio was sentenced to 78 months' imprisonment, co-defendant Dayron Porrata was sentenced to 84 months' imprisonment, and co-defendant Wally Proenza was sentenced to 17 months' imprisonment for their respective roles in two fraud schemes.

Medicare HIV-Infusion Fraud Scheme

The first conspiracy alleged that Huarte and other conspirators operated and controlled six purported medical clinics in Miami Dade County. According to the Indictment, these clinics submitted at least $50.2 million in false and fraudulent claims to Medicare for infusion therapy, injection therapy, and other expensive medical treatments designed treat Medicare beneficiaries suffering from a wide variety of ailments including cancer, HIV, AIDS, chronic pain, and varicose veins. Based on these fraudulent claims, Huarte and his conspirators were paid at least $19.2 million.

To conceal their involvement in the scheme, Huarte and his conspirators recruited nominee or “straw” owners for each company, and paid them large sums of cash to sign the corporate records, bank records, and other business documents.

The six purported clinics involved in the fraud were Zigma Medical Care, Inc., Tender Loving Care Medical Center, Inc, Professional Medical Health, Inc., Metro Med Care, Inc., San Diego Medical & Rehab Center, Inc., and Eulogia's Diagnostic Medical Center, Inc.

Multistate Medicare Advantage Fraud Scheme

Huarte was involved in a second Medicare fraud conspiracy along with co-defendants Alyd Dazza, Ricco Dazza, Monika Blacio, and Dayron Porrata. In the second conspiracy, Huarte and his conspirators expanded the Medicare fraud scheme by opening twenty-nine (29) medical clinics in Florida, Georgia, Louisiana, North Carolina, and South Carolina. Many of the clinics were simply P.O. Boxes, or empty, abandoned storefronts. These sham medical clinics collectively submitted approximately $55.5 million in false and fraudulent claims to various private insurance companies that offered coverage to Medicare beneficiaries through Medicare Advantage programs. Based on these false and fraudulent claims, the Medicare Advantage programs paid approximately $14.6 million dollars to the sham clinics. A substantial portion of the billings were for expensive cancer and HIV medications that are often administered via infusion treatments, i.e., the insertion of a needle into a patient's vein.

According to court documents, the final defendant, Wally Proenza stole and sold the identities of 718 Medicare beneficiaries living in at least five (5) states. Proenza stole the identities from from his employer where he had access to personal identifying data of millions of Medicare beneficiaries. Proenza then sold the identifications to co-defendant Dayron Porrata. Porrata transferred the identifications to other conspirators, including Huarte, who utilized the Medicare beneficiaries identifications to submit false and fraudulent claims through the twenty-nine (29) sham clinics located in Florida, Georgia, Louisiana, North Carolina, and South Carolina.

Mr. Sloman commended the investigative efforts of the Federal Bureau of Investigation, Internal Revenue Service, Broward Sheriff’s Office, and the Florida Department of Law Enforcement. This case is being prosecuted by Assistant United States Attorneys Ryan Stumphauzer, Dan Bernstein, and Alison Lehr.