Miami Herald - December 18, 2008
Jay Weaver, jweaver@MiamiHerald.com

Thomas McKenzie, who taught doctors how to prescribe HIV therapy at Miami-Dade clinics to defraud the national healthcare system, had hoped to receive an 11-year prison term recommended by prosecutors.

But U.S. District Judge Alan Gold said he didn't think the lower sentence went far enough to deter other Medicare fraud perpetrators in Miami-Dade County, which is regonized as the nation's capital of healthcare corruption.

Gold said the magnitude of McKenzie's role in the scam was "great" because he used his expertise to train doctors to prescribe "medically unnecessary" HIV infusion treatments for roughly 500 patients at the expense of other Medicare beneficiaries.

"It is a serious crime," Gold said. "It takes away millions of dollars from those in the community who are in need of Medicare services."

McKenzie, a 53-year-old Nicaraguan native, is among a growing group of convicted defendants -- doctors, administrators and assistants -- who are pleading guilty in exchange for providing federal prosecutors inside information about the alleged Medicare racket built by Carlos, Luis and Jose Benitez.

The Cuban 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 insurance program. They fled to Cuba before prosecutors unsealed an indictment in June charging them and McKenzie in the sprawling Medicare fraud case.

McKenzie admitted he played a central role in their alleged criminal enterprise, which collected $84 million from Medicare based on at least $119 million in false claims for HIV infusion treatments.

"McKenzie facilitated thousands of medically unnecessary services provided to HIV-positive Medicare beneficiaries, and doctored file after file to make those worthless services appear legitimate," prosecutors said in court papers.

"McKenzie's punishment should take into consideration the severity and scope of his criminal conduct and the need to deter the rampant Medicare fraud problems in South Florida, which have been undeterred to date."

The Benitez brothers are accused of not only defrauding Medicare but also laundering their dirty profits through sham companies and investing much of it in real estate and other assets in the Dominican Republic. U.S. authorities have been seizing their properties in that country and say the brothers themselves are being held in jail by the Cuban government on immigration violations.

Meanwhile, McKenzie has joined at least 10 other defendants who have pleaded guilty for their roles in the brothers' network of a dozen HIV clinics in Miami-Dade County.

In September, McKenzie pleaded guilty to one count of healthcare fraud conspiracy and one count of submitting false Medicare claims, but he began providing critical information to authorities about the brothers soon after their indictment was unsealed in June.

McKenzie was a vital witness in the prosecution of Dr. Ana Alvarez-Jacinto, a physician at one of the brothers' clinics. She was convicted at trial in October and on Wednesday sentenced to 30 years in prison -- one of the longest Medicare fraud sentences in history.

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

McKenzie, who had studied medicine in Central America before leaving for the United States in the early 1980s, confessed he oversaw the clinics' records for HIV therapy treatments -- which were not provided in most instances -- to ensure the services appeared legitimate to Medicare claims contractors.

HIV 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, healthcare experts say.

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

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