As part of the Medicare Fraud Strike Force that has been operating in Miami since March 2007, three Miami-area brothers who allegedly financed 11 "corrupt" HIV infusion clinics and a physician's assistant who worked at those clinics have been charged in a $110 million HIV infusion fraud scheme.
According to the Department of Justice's Criminal Division and the U.S. Attorney's Office for the Southern District of Florida, between January 2001 and November 2004, Carlos and Luis Benitez conspired to submit approximately $110 million in false and fraudulent claims to the Medicare program for HIV infusion services allegedly provided at 11 HIV infusion clinics that they owned and controlled.
Carlos and Luis Benitez allegedly referred Medicare beneficiaries to the clinics and directed the beneficiaries to be paid kickbacks to induce them to claim they received legitimate services at the clinics, when in fact the HIV infusion services were either not provided or were not medically necessary, the DOJ said.
The HIV infusion clinics were identified as AH Medical Office Inc., Advanced Medical Rehabilitation Center Inc., Best Medi Corp., Physician's Health Med-Care, Physician's Med-Care Inc., Saint Jude Rehab Center Inc., Global Med-Care Corp., CNC Medical Corp., G&S Medical Centers Inc., Karla Medical Services Inc. and Best Medicare Inc.
Jose Benitez also owned and operated Advanced Medical, one of the 11 clinics, and assisted in submitting approximately $10 million of the false and fraudulent claims, according to reports.
Thomas McKenzie was a physician's assistant at the HIV infusion clinics; the indictment alleges that, under orders, he was responsible for training physicians and providers in how to make it appear that legitimate and appropriate medical services were being provided as well as overseeing the preparation of documents to make it appear that the services were actually rendered and medically necessary.
The indictment seeks forfeiture of assets held by all defendants. Carlos and Luis Benitez each face a maximum sentence of 155 years in prison, Jose Benitez faces a maximum of 40 years, and Thomas McKenzie faces a maximum of 50 years.