Wednesday, May 25, 2011

Miami-Area Owners and Operators of Medical Equipment Company Plead Guilty to Medicare Fraud

WASHINGTON—Two Miami-area residents who were owners and operators of a durable medical equipment (DME) company pleaded guilty today to their roles in a scheme to defraud Medicare, the Departments of Justice and Health and Human Services (HHS) announced.

Obel Martinez and Damaris Gil, a married couple, each pleaded guilty before U.S. District Judge Donald M. Middlebrooks in the Southern District of Florida to one count of conspiracy to commit health care fraud.

According to plea documents, Martinez and Gil incorporated and operated OM Best Help Corp. in 2006 for the purpose of defrauding Medicare. OM Best purportedly specialized in the provision of DME and prescription drugs to Medicare beneficiaries.

According to court documents, starting in 2008, Martinez and Gil submitted and caused the submission of approximately $1,089,234 in fraudulent claims to the Medicare program. The defendants and their co-conspirators used without authorization the Medicare billing identifiers of licensed medical doctors and falsely represented to Medicare that the doctors had prescribed DME, when, in fact, the doctors had not done so. The defendants also knew that the Medicare beneficiaries, on whose behalf claims were submitted to Medicare by OM Best, never received the items OM Best billed to Medicare.

Sentencing for Martinez and Gil is scheduled for Aug. 23, 2011. Each defendant faces a maximum of 10 years in prison.

Today’s guilty pleas were announced by Assistant Attorney General Lanny A. Breuer of the Criminal Division; U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida; John V. Gillies, Special Agent-in-Charge of the FBI’s Miami field office; and Special Agent-in-Charge Christopher Dennis of the HHS Office of Inspector General (HHS-OIG), Office of Investigations Miami office.

This case was prosecuted by Trial Attorney Sarah M. Hall of the Criminal Division’s Fraud Section. The case was investigated by the FBI and HHS-OIG, and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida.

Since their inception in March 2007, Medicare Fraud Strike Force operations in nine locations have charged more than 1,000 defendants who collectively have falsely billed the Medicare program for more than $2.3 billion. In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to stopmedicarefraud.gov.

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