Important note: Information in this article was accurate in 2008. The state of the art may have changed since the publication date.
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Miami Herald - January 24, 2008
Erika Beras, eberas@MiamiHerald.com
Alexis Dagnesses, 43, a registered nurse, was arrested at his house and charged with one count of organized scheme to defraud.
In the scheme, a clinic was billed for unnecessary HIV medications that were in many cases not given to patients.
The case, which began in summer 2005, involved Miami clinics T&R Rehabilitation Professional Corp. and American Medical Applications.
FDLE agents, federal Health and Human Services officials and the Medicaid Fraud Control Unit took part in the investigation.
Agents said Dagnesses' role in the scheme was to alter blood samples that had been taken from HIV patients so that the clinics could bill Medicare for expensive but unnecessary treatments for those patients.
Investigators said Dagnesses would remove the patients' blood samples from the clinic and return them after they had been altered. Once they were returned to the clinic, the samples were sent to a legitimate lab for analysis.
In many cases, the altered samples came back showing very low platelet counts, which indicated the patients were sicker than they really were.
Those patients were told by the clinic that they needed certain medications to raise their platelet counts.
The clinic then billed Medicare for the medications.
In some cases, agents said, the medications were administered in smaller doses than those billed or were not administered to the patients at all.
When those same patients went to different facilities and doctors not associated with the clinics, their platelet counts came back at higher levels.
The scheme netted the clinics several million dollars from July 2003 to July 2005.
Dagnesses allegedly received at least $50,000, investigators said.
Several other people connected to the clinics were arrested in March 2006 and September 2006.
Dagnesses is being held in jail on $250,000 bond.
Records show he is the president of two Miami-Dade based companies: Health and Life Inc. in Southwest Miami-Dade and American Urgent Care Networking in Doral.
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