On September 4, 2009, a seven-count Indictment was unsealed charging Alejandro Rodriguez, 53, of Miami-Dade County, with health care fraud, in violation of Title 18, United States Code, Section 1347. Each count carries a maximum of ten years’ imprisonment.
According to the Indictment, in February, 2000, Rodriguez acquired Complete Medical Center, Inc., (“CMC”) a Miami-based company that purportedly provided durable medical equipment (“DME”) to Medicare beneficiaries. Rodriguez obtained and maintained control of CMC by purchasing all of the shares of stock of CMC and by registering as the President, Vice-President, Secretary, Treasurer, Director, and Registered Agent of CMC with the State of Florida, Division of Corporations.
In April, 2000, Rodriguez notified Medicare that he was the new owner of CMC, the only officer and director of CMC, and the authorized representative for CMC. Later that month he opened up a business checking account for CMC, and was the sole signatory on that account. From the spring of 2000 through June 2008, CMC allegedly submitted approximately $3,570,502 in fraudulent claims to Medicare seeking reimbursement for DME items, such as oxygen concentrators, wheelchairs, and mattresses.
The Indictment alleges that Rodriguez falsely represented that these DME items and other services were prescribed by a doctor and had been provided to Medicare beneficiaries. As a result of such alleged false and fraudulent claims, Rodriguez caused Medicare to make payments to CMC in the approximate amount of $1,590,265, at least $280,157 of which was deposited into CMC’s business checking account.
An Indictment is only a charge and is not evidence of guilt. A defendant is presumed innocent and is entitled to a fair trial at which the government must prove guilt beyond a reasonable doubt.
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/.
Attorney Commentary: The health care fraud cases continue to be filed and Florida has more than its fair share with California and New York not far behind. Recently Florida has enacted state legislation to require certain health care businesses to post bonds. Florida is one of the few states in the United States that does not have a ban on the corporate practice of medicine. This means that non-licensed professionals can own medical offices and other health care offices.
We can expect other states such as California to consider requiring similar bonds for companies in the Medi-Cal program. The legality of such bonds might be an issue but to date the bar for opening a DME company and other health care businesses has been low in California and Florida. I expect the state legislatures to take some action in order to make it more difficult for companies to become Medicare or Medicaid/Medi-Cal providers. It appears that one of the problems is that provider enrollment does not conduct an adequate investigation before issuing provider numbers and allowing those providers to engage in good faith billing.
Any questions or comments should be directed to: tgreen@greenassoc.com. Tracy Green is a principal at Green and Associates in 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 health care fraud cases. Their website is: http://www.greenassoc.com/
