Fla. Convicts 21 Defendants for Medicaid Fraud

Marcos Daniel Jiménez, United States Attorney for the Southern District of Florida; Linda Little, Special Agent in Charge, Office of the Inspector General, U.S. Department of Health and Human Services; and Michael Clemens, Special Agent in Charge, Federal Bureau of Investigation, announced the filing of additional charges, by way of an Information, against defendant, Patricia Garcia, in connection with their investigation of a massive kickback network involving local assisted living facilities, medical equipment companies, pharmacies, and physicians, in violation of Title 18, United States Code, Section 371. To date, 21 people have been convicted of kickback and Medicare fraud charges in connection with this investigation.

The charges involve, defendant Garcia, who, along with other family members, operated several medical equipment companies and a pharmacy in Miami-Dade County.

Between approximately January 1999 and April 2004, Garcia and her co-conspirators reportedly established arrangements with numerous Medicare beneficiaries who agreed to let Garcia and her co-conspirators use their Medicare numbers to submit fraudulent Medicare claims for unnecessary respiratory equipment and related medications, in return for monthly kickback payments.

In order to obtain the necessary prescriptions to submit these claims, Garcia and her co-conspirators also reportedly paid collusive physicians who would sign prescriptions in which they falsely certified the medical necessity of such equipment and medications. After receiving the fraudulent prescriptions, Garcia and her co-conspirators would deliver the equipment and a monthly supply of medications to the beneficiaries and then submit Medicare claims seeking reimbursement for the cost of such equipment and medications.

During the course of the scheme, Garcia and her co-conspirators received more than $1 million from the Medicare program for fraudulent medication and prescription claims.

Garcia also was involved in a second scheme in which she reportedly paid illegal kickbacks to medical equipment owners in return for their referral of patients to her pharmacy, Diana Pharmacy Discount Inc. The medical equipment owners would refer patients who purportedly needed respiratory medications to Diana. Garcia and her co-conspirators would deliver respiratory medications to the referred patients on a monthly basis and then bill Medicare each month for the cost of such medications.

After receiving the monthly payment from Medicare, Garcia and her co-conspirators would reportedly kickback approximately 50 percent of the payment to the medical equipment owners as a referral fee.

During the course of the scheme, which spanned from January 1999 through April 2004, Garcia and her co-conspirators paid more than $2.2 million in illegal kickbacks to medical equipment owners in return for their referrals. Garcia faces a maximum statutory sentence of 10 years on these charges.