A
Miami-area resident who owned and
operated an HIV infusion clinic was arrested today and charged for her
alleged participation in a
$23 million HIV
infusion Medicare fraud scheme, the Departments of Justice and Health
and Human Services (HHS) announced.
An indictment unsealed
today in U.S. District Court in Miami
charges Flor Crisologo, 58, with one
count of conspiracy to defraud the United
States, to cause the submission of false claims to the Medicare
program, and to pay health care kickbacks; one count of conspiracy to
commit health care fraud; and three counts of submitting false claims to
the Medicare program. Crisologo also is charged with one count of
conspiracy to launder the proceeds of her crimes and four counts of
money laundering. Crisologo made her initial appearance today in U.S.
District Court in Miami before
Magistrate Judge William C. Turnoff.
According to the
indictment, Crisologo was the owner and operator of J & F Community
Medical Center Inc. The indictment alleges that Crisologo submitted
approximately $23 million in false and
fraudulent claims to the Medicare program for HIV injection and infusion
services purportedly provided through J & F. According to the
indictment, Crisologo hired a physician at J & F and caused the
physician to order unnecessary tests, sign false medical analyses and
diagnosis forms, and authorize treatments to make it appear that medical
services were being provided to patients who were Medicare
beneficiaries. The services included medically unnecessary injection
and infusion therapies. The indictment alleges that Crisologo and her
co-conspirators paid Medicare beneficiaries kickbacks to induce the
beneficiaries to claim they received legitimate services at the clinic
when in fact the HIV infusion services were either not provided or were
not medically necessary.
According to the
indictment, Crisologo engaged in a scheme to launder the proceeds of the
fraudulent Medicare claims by, among other things, transferring
thousands of dollars in proceeds to two shell corporations that she
owned and controlled, ABC Med Way Inc., and MSG Investment and Services
Corp.
The maximum sentence
for each count of conspiracy to defraud the
United States and filing false claims is five years in prison.
The maximum sentence for each count of conspiracy to commit health care
fraud, conspiracy to commit money laundering and money laundering is 10
years in prison. The indictment seeks forfeiture of assets held by the
defendant.
An indictment is merely
a charge and defendants are presumed innocent until proven guilty.
Today's charges were
announced by Assistant Attorney General Lanny A.
Breuer of the Criminal Division; U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida; John V.
Gillies, Special Agent-in-Charge of the FBI's Miami field office; and Special
Agent-in-Charge Christopher Dennis of the HHS Office of Inspector
General (HHS-OIG), Office of Investigations Miami office.
This case is being
prosecuted by Trial Attorney Joseph S.
Beemsterboer of the Criminal Division's Fraud Section. The case
was investigated by the FBI and HHS-OIG, and was brought as part of the
Medicare Fraud Strike Force, supervised by the Criminal Division's Fraud
Section and the U.S. Attorney's Office for the Southern District of
Miami.
Since their inception
in March 2007, Strike Force operations in
seven districts have obtained indictments of more than 560 individuals
who collectively have falsely billed the Medicare program for more than $1.2 billion. In addition, the HHS Centers for
Medicare and Medicaid Services, working in conjunction with the
HHS-OIG, are taking steps to increase accountability and decrease the
presence of fraudulent providers.
To learn more about the
Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to:www.stopmedicarefraud.gov.
SOURCE U.S. Department of Justice
