A Miami man has been sentenced to 57 months in prison for his role in a Medicare fraud scheme involving a Miami-area HIV clinic, authorities said.
Jose Garcia, 55, was sentenced Monday in U.S. District Court in Miami to 57 months in prison for his participation in the Medicare fraud scheme, which involved his medical clinic, Global Med-Care Corp. Inc.
Garcia pleaded guilty in August 2010 to one count of conspiracy to cause the submission of false claims to the Medicare program and to pay health care kickbacks, and one count of conspiracy to commit health care fraud.
According to court documents, Garcia operated Global Med-Care, which purported to specialize in treating patients with HIV, and caused the clinic to submit claims to the Medicare program for expensive HIV medication that was medically unnecessary or never provided.
In return for a share of Global Med-Care’s profits, Garcia agreed with his co-defendant Nayda Freire and others to oversee the staff necessary to operate the clinic, the Medicare patients whom the clinic billed to the Medicare program, and the transportation for the patients.
Garcia admitted he knew that Global Med-Care would need to pay kickbacks to its patients and that the clinic could bill Medicare for HIV infusion services three times a week, for up to three months, for each patient.
Garcia also admitted that from April 2003 through August 2003, Global Med-Care submitted approximately $10.9 million in claims to the Medicare program for HIV infusion services that were never provided and/or medically unnecessary.
Freire pleaded guilty in August 2008 to one count of conspiracy to defraud the Medicare program, and was sentenced by Judge Jordan on Nov. 12, 2008, to 30 months in prison.
The scheme was part of a larger HIV infusion fraud and money laundering scheme that involved Global Med-Care and 10 other HIV infusion clinics, which allegedly caused approximately $109 million in losses to the Medicare program.
Garcia was ordered to pay, jointly and severally with his co-conspirators, restitution of $7,992,391.
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Key Facts
- State: Federal
- Category: Fraud & Financial Crimes|White Collar Crime
- Source: DOJ Press Release ↗
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