Patient Recruiter Sentenced to 30 Months in Prison in Connection with $5.4 Million Medicare Fraud Scheme

WASHINGTON—A Miami resident was sentenced in Detroit today to 30 months in prison for his participation in a $5.4 million Detroit-area Medicare fraud scheme, announced the Department of Justice, FBI and Department of Health and Human Services (HHS).

Santiago Villa-Restrepo, 34, was sentenced by U.S. District Judge Arthur J. Tarnow of the Eastern District of Michigan. In addition to his prison term, Villa-Restrepo was ordered to pay approximately $2.9 million in restitution, jointly and severally with his co-defendants.

Villa-Restrepo pleaded guilty on Nov. 29, 2011, to one count of health care fraud. According to the plea documents, beginning approximately in 2007, Villa-Restrepo paid Medicare patients to undergo medically unnecessary diagnostic tests at three health care clinics owned by co-conspirators. In exchange for cash and other consideration offered by Villa-Restrepo and his co-conspirators, the Medicare beneficiaries signed documents indicating they had received the services billed to Medicare. Medicare was billed $5.4 million for medically unnecessary diagnostic tests by the clinics associated with the scheme.

The sentencing was announced by Assistant Attorney General Lanny A. Breuer of the Criminal Division; U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade; Special Agent in Charge Andrew G. Arena of the FBI’s Detroit Field Office; and Special Agent in Charge Lamont Pugh III of the HHS Office of Inspector General’s (OIG) Chicago Regional Office.

This case is being prosecuted by Assistant U.S. Attorney Philip A. Ross of the Eastern District of Michigan, with assistance from Assistant Chief Benjamin D. Singer 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 Eastern District of Michigan.

Since their inception in March 2007, the Medicare Fraud Strike Force operations in nine districts have charged more than 1,140 individuals who collectively have falsely billed the Medicare program for more than $2.9 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, is 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.