A federal jury convicted a Miami-based doctor on five felony counts for his role in a $23 million Medicare fraud scheme involving HIV injection and infusion treatments from April 2003 through October 2005 that were neither medically necessary nor provided.
Fla. doc convicted in $23 million fraud scheme
In a three-week trial, Dr. Rene De Los Rios, an internist and geriatric specialist, was found guilty last week of one count to commit healthcare fraud and four counts of submission of false Medicare claims. He faces a maximum 10-year prison sentence and $250,000 fine on the conspiracy conviction and five years on each of the false claim charges, according to a Justice Department news release. Sentencing is set for June 27.
According to the release, the Metro Med HIV infusion clinic hired De Los Rios to order unnecessary tests, sign medical-analysis and diagnosis forms and authorize treatments to Medicare beneficiaries. It also said De Los Rios signed charts—often without seeing patients—diagnosed the patients with a rare blood disorder he knew they did not have, and prescribed expensive medications such as Winrho, Procrit and Neupogen "for the sole purpose" of receiving Medicare reimbursement. De Los Rios received $3,000 a week for his services, according to the release.
Metro Med reportedly submitted $23 million in Medicare claims in this scam and received $11.7 million in payments. Patients also reportedly received cash kickbacks in exchange for the use of their Medicare numbers. Four other individuals have pleaded guilty in connection with the scheme.
Calls to De Los Rios' office were not answered. According to the Florida Health Department website, his medical license, originally issued on April 13, 1976, was clear and active, and there were no complaints, disciplinary actions or—as of June 23, 2010—criminal offenses in his file. The indictments in this case were filed on July 19, 2010.
The case was investigated by the FBI and HHS as part the Medicare Fraud Strike Force program launched in February 2007.
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