Four Miami-area residents were recently sentenced for a $10 million Medicare fraud scheme involving HIV infusion clinics.
Alexis Dagnesses, Gonzalo Nodarse, Alexis Carrazana and Dr. Carlos Garrido all pled guilty in March before U.S. District Judge Paul C. Huck to one count each of conspiracy to commit healthcare fraud.
Dagnesses was sentenced to 90 months in prison, followed by a three-year-term of supervised release, and ordered to pay $12.4 million in restitution. Nodarse was sentenced to 78 months in prison, with a three-year-term of supervised release, and ordered to pay $5.1 million in restitution. Carrazana was sentenced to 72 months in prison, followed by three years of supervised release, and ordered to pay $3.6 million in restitution. Garrido was sentenced to 37 months in prison and three years of supervised release and ordered to pay $747,000 in restitution.
All four defendants worked at Midway Medical Center, Inc., a Miami clinic that appeared to specialize in the treatment of patients with HIV. According to court documents, most of the services allegedly provided to patients at Midway were billed to the Medicare program as treatments for a diagnosis of thrombocytopenia, a disorder involving a low count of platelets in the blood, though none of Midway’s patients had low blood platelet counts.
Dagnesses' admitted role at Midway was to manipulate the blood samples drawn from the clinic’s patients before the blood was sent to a laboratory for analysis so that the resulting laboratory reports would make it appear that the patients had dangerously low blood platelet counts. He was generally paid $1,000 for every vial of blood that he manipulated.
Dagnesses was also found to have engaged in similar conduct at two additional fraudulent HIV infusion clinics, and he was held accountable for conspiring to cause the submission of more than $20 million in fraudulent claims at the three clinics.
Nodarse and Carrazana worked at Midway as medical assistants. In their pleas, the two admitted to making false entries in medical records that indicated they had provided medications on particular dates and in particular dosages to patients when, in fact, they had not.
Garrido was a part-owner and practicing physician at Midway. He admitted that he and the others billed the Medicare program routinely for services that were medically unnecessary and in many instances never provided. He also admitted to purchasing only a small fraction of the medication that was supposedly being administered to Midway’s patients and ordering patients to be treated with medications he knew they didn't need and, in many instances, the clinic didn't have available.
Federal prosecutors have indicted 108 cases with 196 defendants in strike force operations since investigations opened in March 2007. Collectively, these defendants fraudulently billed the Medicare program for more than $577 million.