by Deb Cupples | Is it any wonder that our nation's health care costs are skyrocketing? Here we have a case of a two doctors and two assistants at a Miami clinic (purporting to specialize in HIV treatment) who spent years going to pretty creative lengths to defraud the U.S. taxpayers out of millions of dollars.
The U.S. Justice Department reports:
"Dr. Roberto Rodriguez, 54; Dr. Carlos Garrido, 69; Gonzalo Nodarse, 38; and Alexis Carrazana, 41; all pleaded guilty before U.S. District Judge Paul C. Huck to one count of conspiracy to commit health care fraud....
"According to the plea documents, Rodriguez was a co-owner of and practicing physician at Midway. Rodriguez admitted that he and his co-conspirators routinely billed the Medicare program for services that were medically unnecessary and, in many instances, never provided. Rodriguez admitted to purchasing only a small fraction of the medication that was purportedly being administered to Midway’s patients.
"Most of the services provided to patients at Midway were billed to the Medicare program as treatments for a diagnosis of thrombocytopenia, a disorder involving a low count of platelets in the blood. According to the plea documents, none of Midway’s patients actually had low blood platelet counts. Rodriguez admitted that to make it appear that the patients actually had low platelet levels, he and his co-conspirators used chemists to manipulate the blood samples drawn from Midway’s patients before the blood was sent to a laboratory for analysis.
"In his plea, Rodriguez admitted to ordering that patients at Midway receive medications to treat thrombocytopenia despite knowing that the laboratory results had been falsified and the patients did not actually have that condition.
"Midway was not the only clinic where Rodriguez purported to treat HIV patients with injection and infusion therapies. In his plea, Rodriguez admitted that he was listed as a medical director and practicing physician for five other Miami-area HIV infusion clinics between approximately October 2003 and February 2005, where he engaged in similar misconduct.
"Specifically, Rodriguez admitted he and his co-conspirators billed the Medicare program for HIV injection and infusion services that Rodriguez knew were medically unnecessary and, in some instances, never actually provided. Rodriguez admitted to causing more than $20 million in false claims to be submitted to the Medicare program at all of his clinics, including Midway....
"Nodarse and Carrazana worked at Midway as medical assistants. In their pleas, the two assistants admitted to making false entries in medical records indicating that they had provided medications on particular dates and in particular dosages to patients, when, in fact, they had not provided medications. The medical assistants also admitted to being fully aware that blood samples drawn from Midway’s patients were tainted to make it appear that the patients had conditions they did not have. Both assistants admitted to administering medications to patients that they knew the patients did not need. Nodarse, who worked at Midway throughout its existence, admitted to conspiring to submit more than $10 million in false and fraudulent claims for HIV infusion services allegedly provided at the clinic." (U.S. DoJ)
I'm glad that Justice caught up with these particular perps. What bothers me is that people at some of the really big companies (e.g., hospital chains, drug companies, pharmacy chains, labs) have robbed us taxpayers of far more than these small clinicians -- and the big dogs tend not to go to prison.
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