Tampa, FL – A Miami couple has been taken down for running a clinic that bilked Medicare out of a staggering $266,423.20. Gladys Fuertes, 40, and her husband Mario Fuertes, 38, were arrested on Wednesday morning in Miami.
The indictment alleges that the pair operated a sham clinic in Coral Gables, Florida, called Gables Medical and Therapy Center. They employed unlicensed medical professionals and used the Medicare billing numbers of other medical professionals without their knowledge to claim they rendered medical treatment to Gables patients.
Gladys and Mario Fuertes also paid a co-conspirator to recruit Medicare beneficiaries and drive them to the clinic for basic and sham medical services. They would then urge the patients to enroll in Universal’s Medicare Part C and Part D plans, which they believed paid a relatively high percentage of claims.
The couple would then fraudulently bill Universal and cause Universal’s Medicare Part C plan to be billed for Gables patients’ supposed treatments, including expensive HIV-related treatments that patients never actually received. They also billed Universal and caused Universal to be billed for services that required a physician’s presence when no licensed physician was present or rendered the service.
The defendants and their co-conspirators paid the Medicare beneficiaries to allow Gables to bill Universal for services that were never rendered. In addition, Gladys and Mario Fuertes facilitated the provision of fraudulent prescriptions for controlled substances, including Oxycodone, to Gables patients. In some cases, the signatures on the prescriptions were forged.
Once they learned of the federal healthcare fraud investigation, Gladys and Mario Fuertes instructed Gables patients to lie to law enforcement agents and obstruct a federal investigation into healthcare fraud at Gables. They also provided altered Medicare billing documentation to federal agents investigating their activities.
An indictment is merely a formal charge that a defendant has committed a violation of federal criminal laws, and every defendant is presumed innocent unless proven guilty. If convicted, each faces a maximum penalty of ten years in federal prison on each of the conspiracy and healthcare fraud counts and five years on each of the obstruction counts, as well as mandatory sentences of two years in prison for each of the aggravated identity theft counts.
Related Federal Cases
- Miami Clinic Owners Face Guilty Pleas in $5.3M Medicare Fraud Scam · Alabama
- Miami Clinic Execs Guilty in $5.3M Medicare Fraud Scam · Florida
- Miami Home Health Boss Pleads Guilty in $6.2M Medicare Fraud · Florida
- Medicare Scam Lands Florida Man 5 Years · New York
- Miami Clinic Owner Pleads Guilty to $5.3M HIV Fraud Scheme · Alabama
Key Facts
- State: Florida
- Category: Fraud & Financial Crimes|White Collar Crime
- Source: DOJ Press Release ↗
ðŸâ€â€™ Get the grimiest stories delivered weekly. Subscribe free →
MORE FEDERAL CRIME NEWS
US NewsUS NewsUS NewsUS News