Miami Herald - August 7, 2009
Jay Weaver, jweaver@MiamiHerald.com

Dr. Keith Russell, 65, and Jorge Luis Pacheco, 50, were also ordered Friday by U.S. District Judge Ursula Ungaro to pay back $3.1 million and $2.6 million, respectively, to the federal healthcare program.

The judge also sentenced another physician's assistant, Eda Marietta Milanes, 43, to five years' imprisonment and to pay back $3.1 million.

All three -- along with another Miami physician, David Rothman, 67 -- were convicted in March of conspiring to defraud Medicare and other charges in a case that stood out because Pacheco tried to flee the country near the end of the trial. Four others charged in the case -- investigated by the Department of Health and Human Services' Office of Inspector General and the FBI -- pleaded guilty before trial.

Rothman, whose sentencing is pending, and Russell are part of a growing list of South Florida doctors and assistants convicted of billing Medicare for hundreds of millions of dollars in fraudulent claims for outdated HIV infusion therapy administered intravenously.

That therapy was replaced about 15 years ago by more effective antiretroviral drugs taken orally, experts say, yet Medicare continues to pay for the infusion therapy because the agency still considers it "medically reasonable and necessary."

Medicare officials say the agency has stopped about $2 billion in "improper payments"

for bogus HIV infusion services in South Florida over the past five years, but the agency and its Florida claims contractor, First Coast Service Options, continue to pay out hundreds of millions of dollars a year.

In the latest prosecution, Russell, Rothman, Pacheco and Milanes served as the medical staff for two Miami-Dade clinics: M&P Group of South Florida and Medcore Group.

The owner of the clinics, Tony Marrero, testified that Rothman was paid $200,000 and Russell $40,000 for writing prescriptions for the outdated intravenous HIV therapy from 2004 to 2006.

Marrero, who owned the clinics with his wife, Belkis, saidhe paid $200 kickbacks to patients for each visit to use their Medicare numbers to submit the bogus bills. One patient testified that he did not have HIV, and another said he used the money to fund a cocaine addiction.

He also testified the medical assistants manipulated blood platelet levels in patient records to justify their treatments to Medicare, and that he obtained fake invoices from a drug wholesaler to show that his clinics had provided the infusion drugs to patients.

Marrero admitted the racket's criminal activity was "despicable."

Pacheco, a former physician in Cuba, tried to flee the United States before the jury began its deliberations in mid-March. He was arrested in the Homestead area with $12,600 in cash and a false Florida driver's license in the name of "Jose Luis Falcon," authorities said.

Before his arrest, Pacheco cut off his ankle monitor in violation of the terms of his bond, and documents seized from him contained multiple contacts in the Dominican Republic, according to prosecutors Kirk Ogrosky and Jay Darden.

Pacheco told police that he was "going fishing."

090807
MH090801

Always watch for outdated information. This article first appeared in 2009. 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, 2009. 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. .