Miami Clinic Owner Pleads Guilty in $5.3M Medicare Fraud Scam

Miami – In a stunning admission, Orlando Pascual Jr., the owner of two Miami medical clinics specializing in treating HIV-positive patients, has pleaded guilty to orchestrating a $5.3 million Medicare fraud scheme.

Pascual, 43, co-owned Medcore Group LLC and M&P Group of South Florida Inc., both charged with submitting fraudulent claims to Medicare between August 2004 and November 2006. The plea was entered on Jan. 7, 2009, in front of U.S. District Judge Ursula Ungaro.

According to Pascual’s plea, the clinics were nothing more than fronts for bilking the government. He admitted that treatments for infused drugs were not necessary and that cash kickbacks were paid to patients for every visit. Pascual also confessed to laundering proceeds from the fraud by writing checks that appeared legitimate, only to have them cashed back with a fee.

Most of the patients at Medcore and M&P were HIV-positive or had false diagnoses of cancer. To bolster the scheme, Pascual and others employed physicians, physician’s assistants, and phlebotomists. They even manipulated blood samples to appear as if they needed treatment, all in an effort to create a veneer of legitimacy for their medical files.

Pascual is no stranger to Medicare fraud; he was previously incarcerated for his involvement in another Miami operation from 2001 to 2003. His sentencing for this latest offense is set for April 3, 2009.

Seven co-defendants are scheduled for trial on Feb. 9, 2009. The case was prosecuted by Deputy Chief Kirk Ogrosky and Assistant Chief John S. ‘Jay’ Darden of the Criminal Division’s Fraud Section, with investigations led by the Department of Health and Human Services and FBI. This is one of over a hundred cases handled by the Medicare Fraud Strike Force, which has indicted more than half a billion dollars in fraudulent billing across Los Angeles and Miami.

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