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Florida Doctor Convicted in $23M Medicare Fraud Scheme

John Commins, for HealthLeaders Media, April 18, 2011

A federal jury has convicted Miami physician Rene De Los Rios, MD, on felony false claims and conspiracy counts for his role in a $23 million HIV injection and infusion Medicare fraud scheme, the Departments of Justice, and Health and Human Services announced jointly.

The conviction, handed up Thursday after a three-week trial, carries a maximum penalty of 10 years in prison and a $250,000 fine for the conspiracy count, and a maximum penalty of five years in prison for the four false claims counts. Sentencing will be June 27, federal prosecutors said.

Evidence at the trial showed that De Los Rios was hired by Damaris Oliva, the convicted owner of Metro Med of Hialeah Corp., a bogus HIV infusion clinic that charged for infusion therapies which were medically unnecessary or not provided, prosecutors said.

Prosecutors said Oliva paid De Los Rios $3,000 a week to order unnecessary tests, sign medical analysis and diagnosis forms, and authorize treatments to make it appear that legitimate medical services were being provided to Medicare beneficiaries. De Los Rios also signed patient charts, often without seeing the patient, indicating that injection and infusion treatments were medically necessary when he knew they were not, prosecutors said.

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