Miami Herald - September 12, 2008
Jay Weaver, jweaver@MiamiHerald.com

Drs. Carlos Contreras, 60, and Ramon Pichardo, 58, pleaded guilty Thursday in federal court in Miami after admitting they operated a Miami clinic on behalf of brothers Carlos, Luis and Jose Benitez. Authorities say the brothers fled to Cuba before their Medicare fraud indictment was unsealed in June.

The Benitezes are accused of operating about a dozen HIV-infusion treatment clinics that collected $84 million in Medicare payments between 2001 and 2004. The brothers, who immigrated to this country in 1995 and became U.S. citizens five years later, funneled millions of Medicare tax dollars through sham companies to finance their purchases of hotels, homes, cars, boats, horses, a helicopter and even a water park, all in the Dominican Republic.

The pair of doctors, who pleaded guilty to conspiracy charges and face up to 10 years in prison, played key roles by writing false prescriptions for fabricated HIV-infusion treatments at CNC Medical Corp. in Miami, according to statements of fact filed with their plea agreements.

CNC Medical, which listed Contreras as the owner, billed Medicare for about $6.8 million and collected $4.2 million in payments from the government program.

"Contreras signed checks drawn on CNC bank accounts, and would use these checks to transfer funds to various corporate entities owned and controlled by Carlos and Luis Benitez and others," according to the statement of facts.

Contreras admitted he transferred about $1.7 million to the Benitez brothers.

Pichardo, a physician employed at CNC, confessed that he worked alongside Contreras in the Medicare scam.

As part of the plot, both doctors paid $100 to $150 kickbacks to patients for each visit to their clinic in exchange for using their Medicare number to bill the health insurance program. The patients visited the clinic three times a week for up to three months, according to court records.

Both physicians, who had also worked at another Benitez-controlled clinic in Miami, admitted the prescribed Medicare treatments were "medically unnecessary," records show.

The scams are especially outrageous because HIV infusion therapy, which entails intravenous drips of medication to boost a patient's immune system, has been replaced almost everywhere but South Florida by more effective antiretroviral drugs taken orally.

Yet federal records show Medicare has continued to allow the obsolete HIV infusion services and to pay hundreds of millions of dollars yearly for the treatments in Miami-Dade because the agency still considers them "reasonable and necessary."

080912
MH080903

Always watch for outdated information. This article first appeared in 2008. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2008. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .