Criminal Justice News

Monday, September 03, 2012

President of Miami Medical Clinic Pleads Guilty to Health Care Fraud Charges

Wifredo A. Ferrer, United States Attorney for the Southern District of Florida; Michael B. Steinbach, Acting Special Agent in Charge, Federal Bureau of Investigation (FBI), Miami Field Office; and Christopher B. Dennis, Special Agent in Charge, U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), announce that defendant Arbilio Yanes pled guilty today to Medicare fraud and related offenses before U.S. District Judge Cecilia M. Altonaga.

More specifically, Yanes pled guilty to one count of conspiracy to commit health care fraud and to pay health care kickbacks (count one); two counts of health care fraud (counts two and three); four counts of payment of health care kickbacks (counts four through seven); four counts of money laundering (counts eight through 11); and two counts of money laundering (counts 12 and 13). Sentencing is scheduled for November 5, 2012. At sentencing, Yanes faces a statutory maximum sentence of up to five years in prison on counts one and four through seven; up to 10 years in prison on counts two, three, 12, and 13; and up to 20 years in prison on counts eight through 11.

According to statements made in court at the plea hearing, Yanes was the president of Research Center of Florida Inc., a purported medical clinic located in Miami-Dade County, Florida. Between October 13, 2003 and November 5, 2004, Research Center submitted claims to Medicare for $21,043,982, almost exclusively for purported treatment of HIV+ Medicare beneficiaries by administration of prescription drugs. Based on these claims, Medicare paid Research Center $11,098,388.93. In fact, Research Center personnel generally administered smaller doses of the medications than the clinic billed in its claims or no treatment at all.

Yanes paid more than $1.6 million to shell companies controlled by outside patient recruiters. Those shell companies did no business with Research Center, but the recruiters located Medicare beneficiaries who were willing to attend Research Center as purported patients and paid the beneficiaries to do so. Yanes also paid himself over $1.3 million in profits from the scheme. Of that sum, Yanes paid more than $650,000 to two shell companies he controlled, which did no business with Research Center.

Efren Mendez, the vice-president of Research Center; Damian Beltran, a medical assistant at the clinic; and Barbara Perez and Caridad Perez, patient recruiters for the clinic, have all previously pled guilty to conspiracy to commit health care fraud in related cases.

Mr. Ferrer commended the investigative efforts of the FBI and HHS-OIG. This case was prosecuted by Assistant U.S. Attorney Marc Osborne.

No comments: