Miami Clinic Owner Admits $5.3M Medicare Scam

MIAMI – Orlando Pascual Jr., 43, has admitted to masterminding a $5.3 million Medicare fraud scheme through two Miami clinics, Medcore Group LLC and M&P Group of South Florida Inc. Pascual pleaded guilty to conspiracy to commit healthcare fraud earlier this month, revealing a systematic effort to bilk the federal healthcare program for unnecessary treatments.

According to court documents, Pascual and his co-conspirators falsely billed Medicare for HIV infusions and injections, often targeting patients who were already HIV-positive or falsely diagnosed with cancer. The scheme ran from August 2004 through November 2006, and involved paying patients cash kickbacks for each clinic visit – incentivizing repeat, medically unnecessary procedures.

The operation wasn’t just about inflated billing; it was about fabricating a need for treatment. Pascual confessed that clinic employees deliberately manipulated patients’ blood samples to *appear* sicker, creating a false paper trail to justify the fraudulent claims. The clinics were, in his own words, “operated for the purpose of defrauding Medicare,” a brazen admission of intent.

To fund the kickback scheme, Pascual and his crew engaged in a complex money laundering operation, writing checks that appeared legitimate to individuals who would cash them and return the funds – minus a fee. This elaborate scheme demonstrates the lengths to which these criminals went to conceal their ill-gotten gains. This isn’t Pascual’s first brush with the law; he’s currently serving time for a previous Medicare fraud conviction related to a durable medical equipment company.

Federal prosecutors are now preparing for the trial of seven co-defendants, slated to begin February 9th. The case is being prosecuted by the Fraud Section of the Criminal Division and investigated by the Department of Health and Human Services, Office of the Inspector General, and the FBI. The investigation is part of the Medicare Fraud Strike Force (MFSF), which has so far indicted 106 cases with 189 defendants in Los Angeles and Miami, resulting in over half a billion dollars in fraudulent claims.

Pascual’s sentencing is scheduled for April 3rd. While an indictment is not proof of guilt, the evidence presented in the plea suggests a calculated and callous disregard for both the Medicare system and the health of vulnerable patients. The feds are sending a clear message: healthcare fraud will be aggressively investigated and prosecuted.