Monday, July 13, 2009

Miami Owners Of Durable Medical Equipment Company Indicted In Medicare Fraud Case



There have been a number of Medicare fraud indictments in Miami, Florida these past two weeks. On June 30, 2009, Jose Luis Perez and Reinaldo Guerra were indicted on charges of conspiracy to commit Medicare fraud, Medicare fraud, and aggravated identity theft in the Southern District of Florida.

Guerra was arrested and Perez allegedly fled the United States for Cuba, Dominican Republic, Mexico or Costa Rica according to government officials.
According to the Indictment, the alleged fraud involved durable medical equipment (DME), which is equipment that can be used in the home on a repeated basis for a medical purpose. Where DME is prescribed or ordered by a physician, an authorized Medicare provider who supplies the equipment to a Medicare beneficiary may be eligible for reimbursement by Medicare.
An indictment contains allegations that a defendant has committed a crime. Every defendant is presumed innocent until and unless proven guilty.

The Indictment charges that Perez and Guerra owned and operated 21 corporations that purported to supply DME to Medicare beneficiaries pursuant to physicians’ prescriptions or written orders, using straw or nominee owners to disguise their control over the companies. They allegedly submitted approximately $179 million in fraudulent claims to Medicare for DME that had not been prescribed or ordered by a physician nor delivered to a Medicare beneficiary.

Based on those claims, Medicare paid the DME companies approximately $56 million. In addition to health care fraud, the defendants were charged with aggravated identity theft for using physicians’ Medicare identification numbers without the physicians’ authorization. Related court documents and information may be found on the website of the District Court for the Southern District of Florida at http://www.flsd.uscourts.gov/ or on http://pacer.flsd.uscourts.gov/.

Medicare Fraud Attorney Comments: For those under investigation for Medicare fraud, bail will be more of an issue in large cases. According to government officials, over 60 persons charged with Medicare fraud have fled the country for mostly Latin American countries. Here is a related articled in the Miami Herald:


In some federal cases, prosecutors are asking there be no bail for those defendants with foreign ties. For smaller investigations, it will still be important to establish an intent to stay and defend the charges. This can easily be done through an attorney who is experienced in these types of matters. In state cases, we are noting larger bail demands that are often linked to the amount of the alleged fraud.

Post-Script/Follow-up: Reinaldo Guerra plead guilty in November 2009 and was sentenced to 14 years in federal prison and ordered to pay $35 million in restitution. Jose Luiz Perez originally went to Mexico and was extradicted from Cancun, Mexico in January 2010. 

Any questions or comments should be directed to: tgreen@greenassoc.com. Tracy Green is a principal at Green and Associates, Attorneys at Law, Los Angeles, California. They focus their practice on the representation of licensed professionals, individuals and businesses in civil, business, administrative and criminal proceedings. They have a specialty in representing licensed health care providers in Medicare audits, Medicare fraud investigations and Medicare fraud claims.

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