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Mail Mix Up Leads to Medicare Fraud Arrests in Miami

 What started as a simple mailroom mistake ultimately led to allegations of an elaborate Medicare drug scam undertaken by secretaries in a Key Biscayne doctor’s office. According to a report in the Tampa Bay Times, a kidney specialist asked her secretary to mail a fanny pack to the doctor’s brother. Instead of receiving the pack, he received a package filled with prescriptions, which were reportedly forged with the doctor’s signature. He alerted the authorities, which prompted an investigation into an elaborate plan that reportedly cost the federal government roughly $7 million.

Practice Highlighted in Previous Report

Last year, the doctor’s practice was highlighted in a report about waste in the Medicare Part D prescription program. At the time, it was reported that the physician’s prescription costs soared from $282,000 in 2010 to almost $5 million in 2012. Despite these suspicious increases, the doctor was reportedly never asked to justify these changes by Medicare.

According to the news report, the doctor’s secretaries wrote the false prescriptions and signed the doctor’s name. They then reportedly gave them to a local pharmacist, who allegedly paid $100 for each of them. The pharmacist then billed Medicare as if the false prescriptions were filled, when in reality, many of them were not.

The first arrest came in February of this year, when the police charged one secretary with 22 counts of conspiracy, fraud and aggravated theft. She was employed at the clinic for a year and a half. She pleaded guilty to two counts of conspiracy, along with one count of identity theft. In March, another office secretary was charged with similar offenses, to which she also pleaded guilty. The doctor is not currently facing any charges. In May, the pharmacy owner was charged with conspiracy and fraud leading to Medicare claims. As stated in the indictment, her pharmacy allegedly received overpayments in the amount of $4.2 million between April 2011 and November 2013. The pharmacist has pleaded not guilty.

In addition to this specific case, prosecutors allege that the pharmacist routinely billed for other doctors’ prescriptions that were never filled. Patients were allegedly paid kickbacks by patient recruiters in exchange for the submission of fraudulent claims.

The High Cost of Medicare Fraud

Not only does this case exemplify the level of Medicare fraud that regularly takes place in the United States, but it also gives specific examples of how everyday people commit these federal crimes on a daily basis. Two of the women in this case are now convicted felons, with federal records. Their lives and families have been forever altered and they are each facing considerable jail time. This is why representation by a knowledgeable attorney is vital for defendants facing charges of Medicare fraud. Due to the challenges in these cases, legal representation should be secured as early as possible in the investigation process.

If you or a loved one is under investigation or facing allegations of Medicare fraud, contact the capable attorneys at Miami based Ratzan & Faccidomo, LLC today at 305-600-3519 for a confidential and free consultation.

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