Roberto Rodriguez, Medicare Fraud, Florida 2009

Roberto Rodriguez, a 54-year-old Miami physician, has been sentenced to 97 months in prison for his role in a Medicare fraud scheme involving HIV infusion services.

Rodriguez was also ordered to pay more than $9 million in restitution to the Medicare program during today’s sentencing hearing before U.S. District Judge Paul C. Huck.

Rodriguez pleaded guilty before Judge Huck on March 23, 2009, to conspiracy to commit healthcare fraud.

In his guilty plea, Rodriguez admitted that he was a co-owner of and practicing physician at Midway Medical Center Inc. (Midway), a Miami clinic that purported to specialize in the treatment of HIV patients.

Rodriguez admitted that, while at Midway, he and his co-conspirators routinely billed the Medicare program for services that were medically unnecessary and in many instances were never provided.

Rodriguez further admitted that he purchased only a small fraction of the drugs that were purportedly administered to patients at the clinic.

Most of the services allegedly provided to patients at Midway were billed to the Medicare program as treatments for thrombocytopenia, a disorder involving a low count of platelets in the blood. According to the plea documents, none of Midway’s patients actually had low blood platelet counts.

Rodriguez admitted that to make it appear that the patients actually had low platelet levels, he and his co-conspirators used chemists to manipulate the blood samples drawn from Midway’s patients before the blood was sent to a laboratory for analysis.

A number of Rodriguez’s co-defendants have already been sentenced for their roles at Midway and related clinics. On June 5, 2009, in a sentencing hearing before Judge Huck, chemist Alexis Dagnesses, 44, was sentenced to 90 months in prison; medical assistant Gonzalo Nodarse, 38, was sentenced to 78 months in prison; medical assistant Alexis Carrazana, 41, was sentenced to 72 months in prison; and physician Carlos Garrido, 69, was sentenced to 37 months in prison.

The case was prosecuted by Trial Attorney John K. Neal of the Criminal Division’s Fraud Section and investigated by the HHS Office of the Inspector General and the FBI. The case was brought as part of the Medicare Fraud Strike Force, supervised by Deputy Chief Kirk Ogrosky of the Criminal Division’s Fraud Section and Acting U.S. Attorney Sloman of the Southern District of Florida.

Collectively, these defendants are alleged to have fraudulently billed the Medicare program for more than $600 million.

Rodriguez’s co-defendant Carmen del Cueto, a physician, is scheduled to be sentenced on Sept. 11, 2009.

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