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Two Clinic Owners Plead Guilty in Infusion Therapy Scam
Raymond and Emelitza Arias, owners and operators of two Detroit-area clinics, pleaded guilty to conspiracy to commit healthcare fraud in relation to an infusion therapy scam that cost Medicare millions.
According to court documents, Raymond Arias, 40, conceived of and oversaw fraud schemes at Elite Wellness LLC and Carefirst Occupational & Rehabilitation Center Inc., two clinics for which he was a beneficial owner. He admitted to paying physicians to refer Medicare beneficiaries to Elite Wellness and to purchasing Medicare beneficiary identifications for the purpose of submitting fraudulent claims to Medicare for expensive infusion therapy services that were not rendered as claimed by Carefirst.
Raymond Arias attempted to hide the Elite Wellness scheme from law enforcement by directing a nominee owner to assume control of the claims submitted and the bank account into which Medicare payments were deposited. After the nominee owner became involved, Raymond Arias and his alleged co-conspirators submitted approximately $10 million in claims over a 3-month period beginning in August 2010.
Raymond Arias directed this nominee to transfer approximately $2.6 million in Medicare payments offshore to Panama and Mexico. Between approximately October 2009 and October 2010, Raymond Arias admitted that he and his alleged co-conspirators at Elite Wellness submitted or caused to be submitted approximately $12.5 million in fraudulent claims to the Medicare program for infusion therapy services that were not rendered. Medicare paid approximately $5.4 million of those claims.
Emelitza Arias, 25, participated with her husband in a scheme to defraud Medicare by submitting claims for expensive infusion therapy services that were not rendered by Carefirst, of which she was also an owner. In an attempt to create an appearance that Carefirst was a legitimate enterprise, Emelitza Arias injected Medicare beneficiaries with vitamins. Emelitza Arias also assumed responsibility for the claims submitted by Carefirst, and managed the bank account into which the fraud proceeds were deposited.
The Ariases each face a maximum potential penalty of 10 years in prison and a $250,000 fine. Sentencing is currently scheduled for February 12, 2013.
The case is being prosecuted by Assistant U.S. Attorney Philip A. Ross of the Eastern District of Michigan and Trial Attorney Catherine K. Dick of the Criminal Division’s Fraud Section. The case was investigated by the FBI and HHS-OIG and 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 Eastern District of Michigan.
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Key Facts
- State: Federal
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release ↗
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