Miami resident Rita Campos Ramirez, the owner of a Medicare billing service, has been sentenced to 10 years in prison for her role in the largest known individual case of Medicare fraud in the history of the program.
According to the Department of Justice, Campos pleaded guilty on Aug. 28, 2007, to one count of conspiracy to commit healthcare fraud and one count of submitting false claims to Medicare.
Campos admitted that between October 2002 and April 2006 she owned and operated R&I Medical Billing Inc., a medical billing company that specialized in submitting bills to the Medicare program on behalf of HIV infusion clinics. She said she knowingly submitted approximately $170 million in fraudulent medical bills to Medicare on behalf of 75 HIV infusion clinics in Miami-Dade County that were part of the scheme. Infusion clinics serve HIV patients by providing prescribed medications intravenously.
The Medicare program paid approximately $105 million of the $170 million in fraudulent bills submitted by Campos, with Campos receiving $5 million for her role in the fraud.
"The rampant billing fraud perpetrated by this defendant squandered millions of dollars in scarce Medicare resources. The healthcare fraud epidemic in South Florida must stop, and the U.S. Attorney's Office will continue to aggressively investigate and prosecute these cases," U.S. Attorney R. Alexander Acosta said.
Campos was sentenced in the U.S. District Court for the Southern District of Florida by Judge Alan S. Gold. In addition her prison sentence, Gold ordered that Campos serve three years of supervised release following her release from prison, forfeit $207,000, her three homes and an automobile and pay $105 million in restitution to the U.S. Department of Health and Human Services.
The Campos case is part of broader investigations by the Medicare Fraud Strike Force into HIV infusion fraud in the south Florida area.