A Miami-based physician has been charged with participating in a $20 million Medicare fraud scheme and distributing oxycodone and other controlled substances, according to court documents.
Roberto A. Fernandez, 51, was charged with one count of conspiracy to commit health care fraud and wire fraud, 11 counts of health care fraud, one count of conspiracy to defraud the United States and pay and receive health care bribes and kickbacks, one count of conspiracy to distribute controlled substances and two counts of distribution of controlled substances, the indictment alleges.
Fernandez allegedly referred Medicare beneficiaries and Medicaid recipients to Calan Pharmacy & Discount Service LLC, a Medicare Part D provider, and several Miami-area home health agencies in exchange for illegal bribes and kickbacks from his co-conspirators, the indictment states. He also submitted false and fraudulent claims through Medicare Part B for services, office visits and procedures that he never provided, such as therapeutic injections and removal of lesions from patients’ faces.
The indictment alleges that Fernandez illegally dispensed controlled substances, including oxycodone and hydrocodone, to his co-conspirators. It further alleges that Fernandez and his co-conspirators caused Medicare to pay at least $4.4 million based on false and fraudulent claims that they caused to be submitted.
The scheme involved the submission of false and fraudulent claims to Medicare and Medicaid, as well as the illegal distribution of oxycodone and other controlled substances, the indictment states. Fernandez was arrested on March 22, 2017, and made his initial appearance today before U.S. Magistrate Judge Andrea M. Simonton of the Southern District of Florida.
The case was investigated by the FBI, HHS-OIG and USSS, and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida. Former Fraud Section Trial Attorney and current Assistant U.S. Attorney Lisa H. Miller of the Southern District of Florida and Fraud Section Trial Attorney Adam G. Yoffie are prosecuting the case.
An indictment is merely an allegation and the defendant is presumed innocent unless and until proven guilty beyond a reasonable doubt in a court of law.
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Key Facts
- State: Federal
- Category: Drug Trafficking|Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
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