Miami Doc Busted in $20M Pain Pill Scam

Miami Doctor Charged in Medicare Fraud Scheme

A 51-year-old Miami doctor has been charged with participating in a $20 million health care fraud scheme involving the submission of false and fraudulent claims to Medicare and Medicaid and the illegal distribution of oxycodone and other controlled substances.

According to the indictment, Roberto A. Fernandez, M.D., who was licensed in Puerto Rico and practicing medicine in Miami, referred Medicare beneficiaries and Medicaid recipients to a Medicare Part D provider and several home health agencies in exchange for bribes and kickbacks. The indictment alleges that Fernandez submitted false and fraudulent claims for services and office visits that he never provided, including therapeutic injections and removal of lesions from patients’ faces.

Fernandez was also charged with illegally dispensing controlled substances, including oxycodone and hydrocodone, to his co-conspirators. The indictment alleges that Fernandez and his co-conspirators caused Medicare to pay at least $4.4 million based on false and fraudulent claims, and Medicare paid a total of $20 million as a result of claims listing Fernandez as the prescribing physician.

The case was investigated by the FBI, the U.S. Department of Health and Human Services Office of Inspector General, and the U.S. Secret Service. Former Fraud Section Trial Attorney Lisa H. Miller and current Assistant U.S. Attorney of the Southern District of Florida and Fraud Section Trial Attorney Adam G. Yoffie are prosecuting the case.

The Medicare Fraud Strike Force, which is operating in nine cities across the country, has charged nearly 3,000 defendants who have collectively billed the Medicare program for more than $11 billion since its inception in March 2007.

An indictment is merely an allegation, and Fernandez is presumed innocent unless proven guilty beyond a reasonable doubt in a court of law.

Fernandez was arrested on March 22, 2017, and made his initial appearance before U.S. Magistrate Judge Andrea M. Simonton of the Southern District of Florida.

Acting U.S. Attorney Benjamin G. Greenberg, Acting Assistant Attorney General Kenneth A. Blanco, and other law enforcement officials made the announcement.

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