A Miami resident and Detroit clinic owner, Arnaldo Rosario, was recently sentenced to 27 months in prison for his role in recruiting patients to three clinics in the Detroit area. According to the FBI, the Medicare fraud scheme involved remuneration to Medicare beneficiaries for visiting the clinics and fraudulently representing that they had received treatments that were either not provided or not medically necessary. The services were then billed to Medicare and the beneficiaries would receive cash kickbacks for their role in the scheme. Rosario was responsible for obtaining cash from the clinics to pay the kickbacks to the beneficiaries and also to other co-defendants for their role in recruiting and paying Medicare patients. Over a span of one year, Medicare had paid approximately $10.8 million to the clinics based on the fraudulent claims. This case was brought as part of the Medicare Fraud Strike Force, which in its four years of operations, has already discovered more than $2.3 billion worth of allegedly fraudulent Medicare claims. Both Miami and Detroit are cities targeted by the Medicare Fraud Strike Force and providers in these cities should be aware of this heightened scrutiny.
If you have any questions regarding the Anti-Kickback Statute, inappropriate remuneration to beneficiaries, medical necessity issues, or any other compliance issues relating to Medicare fraud or allegations of Medicare fraud, please contact a Wachler & Associates attorney as 248-544-0888.