Miami Herald - January 2, 2008
Jay Weaver, jweaver@MiamiHerald.com

Jorge Ramirez, the one-time owner of a Miami clinic that treated blood disorders, was arrested in December and charged with defrauding Medicare of $42.2 million. Ramirez and two codefendants -- Eugenio and Maricel Hernandez, accused of $73 million in Medicare fraud -- had been indicted a year ago. The FBI said they all fled to Cuba.

Garcia, Ramirez and the Hernandezes are among dozens of Cuban immigrants who evade prosecution by fleeing to their native country. Prosecutors say they bilked the health insurance program out of millions through complex Medicare fraud schemes that have been operating with lax oversight in South Florida for more than a decade.

"There are a number of healthcare fraud defendants from Cuba, and after they commit their crimes many of them return home," FBI spokesman Judy Orihuela said. "Once they're in Cuba, it's very difficult for us to get them back -- unless they return."

Alcides Garcia is the latest fraud suspect to flee the country. Indicted in June, he's charged with submitting $10.7 million in false claims for powered air mattresses, feeding pumps and other medical equipment that were never provided to patients. His business, A&Y Medicare Supply Inc., collected $2.2 million in Medicare payments from 2002 to 2004.

In court papers, prosecutor Daniel Bernstein said Garcia submitted his false Medicare claims through All-Med Billing Corp., headed by a Miami Lakes couple convicted last year after filing $420 million in phony claims on behalf of 85 medical equipment companies in South Florida.

Garcia, who had a $200,000 bond, fled the country to Cuba on Sept. 17 -- 12 days before his federal trial was to start in Miami, according to the FBI.

His attorney, George Vila, declined to comment.

The exploding problem of Medicare fraud defendants fleeing the country registered on the chief federal judge's radar screen last March.

A Miami Herald investigation first spotlighted the phenomenon of Cuban immigrants dominating Miami-Dade's Medicare fraud industry in August. Court records showed that in many instances, fraud suspects were able to easily escape to Cuba before they were charged and prosecuted.

Originally, The Miami Herald reported there were 56 fugitives -- among some 700 others charged with defrauding Medicare of $272 million in South Florida since 2004. Collectively, the fugitives absconded with at least $142 million in taxpayer funds.

Only one -- Jorge Ramirez, arrested at Miami International on Dec. 12 after traveling from Cuba -- has been caught.

His indictment was unsealed after his arrest.

Collectively, Ramirez and the Hernandezes filed $115 million in phony Medicare claims for treating patients with blood disorders such as lymphoma. But the services, charged in 2005, were never rendered, according to the indictment. Their three Miami-Dade clinics received at least $11.6 million in Medicare payments, which were laundered through sham companies, the indictment alleges.

The most notorious among the roughly 60 Medicare fraud fugitives are Carlos, Luis and Jose Benitez, who submitted $119 million in false claims for HIV infusion therapy to the nation's health insurance program.

The brothers, whose Medicare millions were largely invested in the Dominican Republic, have been jailed in Cuba on immigration violations since September, according to federal authorities. But because the United States has no formal relations with Cuba, there's no indication they might be turned over for prosecution in Miami.

Last year, U.S. District Judge Federico Moreno raised the issue of scam artists fleeing the country in a memo to magistrate judges in South Florida, cautioning them about flight risks. He also reviewed Medicare defendants' bonds in cases before him, citing the unusual pattern of defendants fleeing after they were charged with Medicare fraud and granted bail.

In June, Moreno said in court that "it seems to me that our thinking has to change -- that someone from Cuba can flee back to Cuba just like someone from Mexico."

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