Miami Herald - September 19, 2008
Jay Weaver, jweaver@MiamiHerald.com

A Miami physician's assistant who taught doctors how to prescribe obsolete HIV therapy in a $119 million Medicare fraud ring pleaded guilty Thursday in a federal case that reverberates from South Florida to Cuba.

Thomas McKenzie, 53, was the right-hand man to a trio of Cuban immigrant brothers who fled to their native country before their Medicare fraud indictment was unsealed in June.

He is among a group of convicted defendants -- doctors, administrators and assistants -- who are providing federal prosecutors inside information about the alleged Medicare racket built by Carlos, Luis and Jose Benitez. The brothers immigrated in 1995 and became U.S. citizens five years later, just before launching their alleged conspiracy to rip off the taxpayer-funded health program.

While U.S. authorities are zeroing in on the three Benitez brothers hiding in Havana, McKenzie has joined 10 other defendants who have pleaded guilty for their roles in the family's network of a dozen HIV clinics in Miami-Dade County.

McKenzie pleaded guilty to one count of healthcare fraud conspiracy and one count of submitting false Medicare claims. He faces up to 15 years in prison.

Prosecutors say the brothers funneled tens of millions of Medicare dollars through sham companies to buy hotels, homes, cars, boats, horses, a helicopter and even a water park, all in the Dominican Republic. FBI agents have teamed up with Dominican police to seize their assets under a federal court order issued in Miami.

On Thursday, McKenzie admitted that from December 2001 to April 2004 he trained physicians at the brothers' clinics how to fabricate records such as prescriptions to support false Medicare claims for "medically unnecessary" drug-infusion services for HIV patients. The patients received $100 to $150 per visit for letting the clinics use their Medicare numbers to bill the government program for the elderly and disabled.

McKenzie also confessed he oversaw the clinics' records for HIV therapy treatments -- which were not provided -- to ensure the services appeared legitimate to Medicare claims contractors.

Among the regular patients: Alexander McCray, 40, with a record of drug-possession arrests. The Opa-locka man has sold his Medicare number to some of the Benitez brothers' HIV drug-infusion clinics on numerous occasions, according to federal authorities. Among them: Saint Jude Rehab Center and Physicians Med-Care, both in Miami.

McCray, who is HIV-positive and eligible for Medicare, told The Miami Herald that he collected tens of thousands of dollars from the clinics -- money he used for his crack-cocaine habit.

Since 2001, HIV clinics -- including some of the brothers' operations -- have billed more than $1.1 million in bogus charges to Medicare using McCray's government-issued number, according to federal claims records. McCray has not been charged as a "professional" Medicare patient, partly because the U.S. attorney's office has not made the prosecution of patients a high priority.

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 that are taken orally.

Medicare has continued to allow the outdated HIV infusion services and to pay hundreds of millions of dollars yearly for the treatments because the agency still considers them "reasonable and necessary."

U.S. authorities said the Benitez brothers' clinics collected about $84 million from Medicare over a three-year period.

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