Miami Herald - December 2, 2005
John Dorschner, jdorschner@herald.com

In what could be the start of a massive crackdown on scams involving HIV/AIDS patients, law enforcement officials announced the arrest of four persons, including two doctors, charged with illegally diverting millions of dollars in drugs.

"Only the tip of the iceberg," said Michael Clemens, special agent in charge of FBI's Miami office. Altogether, Clemens estimated crooks are using many different cons to bilk Medicare and Medicaid for about $1 billion a year in South Florida alone.

In one of 12 medical fraud cases announced at a news conference Thursday, Onelio S. Baez was charged with directing patient recruiters, including Juan Carlos Mateo, to "recruit and pay kickbacks to Medicaid patients to visit certain medical clinics," federal prosecutors alleged in a statement.

At the clinics, physicians Jorge Arnaldo Valido and Luis Jancito Marti wrote allegedly unnecessary prescriptions for intravenous immune globulin drugs, which can cost several thousand dollars per injection. Fifteen of the 20 patients who participated didn't even have AIDS and none received the drugs Medicaid was billed for, law enforcement officers said.

The drugs instead were "diverted to another Miami pharmacy and resold for profit," the statement alleged.

The four defendants could not be located for comment.

The investigation was an effort of the FBI, the staffs of U.S. Attorney R. Alexander Acosta and Florida Attorney General Charlie Crist, along with federal Medicare and Medicaid officials.

At the news conference, held on World AIDS Day, U.S. Attorney Acosta reported his staff had brought 28 healthcare fraud cases involving 64 defendants since June. "I hope this [healthcare fraud] becomes one of the crown jewels of this office," Acosta said.

In June, The Herald reported that clinics in Broward and Miami-Dade were recruiting AIDS/HIV patients, many of them poor or homeless, for expensive treatments that were charged to Medicare. The patients get paid $100 to $300 for a trip.

Two AIDS doctors have told The Herald that these expensive injections -- for which Medicare pays up to $6,000 -- are almost never necessary for patients, but Clemens said these cases are hard to prosecute.

"It becomes a matter of medical necessity," the FBI agent told The Herald. "So then you have one doctor in court saying one thing, and another doctor saying the opposite." Federal officials said then they had blocked more than $200 million in dubious payments to these subjects, but Broward activists told The Herald they were alarmed that many clinics were still operating.

The AIDS drug case announced Thursday stems from the four defendants' activities in 2000 and 2001.

Clemens of the FBI acknowledged such cases are "a complicated type of investigation," often involving thousands of pages of documents.

Acosta said his office and the FBI had just set up "a quick-hit team" to deal with healthcare fraud cases more quickly, particularly smaller ones that law enforcement had been ignoring in the past.

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