Important note: Information in this article was accurate in 2009. The state of the art may have changed since the publication date.
Miami Herald - Friday, May 15, 2009
Jay Weaver, jweaver@MiamiHerald.com
Two of the men -- Michel De Jesus Huarte and Ramon Fonseca -- operated 19 medical clinics in Florida, Georgia, Louisiana, North Carolina and South Carolina that billed the federal healthcare program for bogus infusion treatments over the past year, according to a criminal complaint.
The false claims for the expensive cancer and HIV therapy, administered intravenously, were submitted to various private insurance companies that offered coverage to Medicare beneficiaries through the Medicare Advantage programs, the complaint says.
Another suspect, Vicente Gonzalez, also arrested this week, was charged along with De Jesus and Fonseca on money-laundering conspiracy charges.
A fourth suspect in the alleged Medicare scam is at large.
The clinic owners deposited millions of dollars in Medicare payments at two Miami-Dade check cashing stores, Universal Money Fast and Rapid Trans Solution, the complaint says.
The owners of the check cashing stores would wait for the checks to clear, then deliver the proceeds to the three men, said Assistant U.S. Attorney Ryan Stumphauzer.
The typical cash deliveries ranged between $30,000 and $80,000 multiple times a week, he said.
According to the complaint, two of the group's medical clinics in New Orleans were empty store fronts with handwritten business signs.
The FBI investigation further showed that two other companies, Ziallet Services and Magestic Services, were post office boxes in North Carolina and South Carolina, respectively.
In one instance, an FBI agent contacted five Medicare beneficiaries whose Medicare Advantage bills showed they had received infusion treatments from Ziallet Services.
"Without exception, the patients confirmed that they had never heard of Ziallet, and never received any medical treatment from Ziallet," according to the criminal complaint.
The FBI tried to reach a sixth purported patient of Ziallet, but failed. Why? The patient had died in 2005, three years before the medical clinic was incorporated, FBI agent Liz Santamaria said in the complaint.
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