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Miami Physician Sentenced to Prison in Medicare Fraud Scheme

Janice Simmons, for HealthLeaders Media, July 1, 2009

Miami physician Roberto Rodriguez was sentenced this week to 97 months in prison for his role in a fraudulent Medicare scheme involving HIV infusion services. Rodriguez was also ordered to pay more than $9 million in restitution to the Medicare program during his sentencing hearing.

Rodriguez, 54, had pleaded guilty before a federal judge in March 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, a Miami clinic that said it specialized in the treatment of HIV patients.

Rodriguez admitted that while working at Midway, he and his co conspirators—including other physicians—billed the Medicare program for services that were medically unnecessary and in many instances were never provided. Rodriguez also admitted that he purchased only a small portion of the drugs that were allegedly administered to the clinic's patients.

Many of the services reportedly provided to Midway patients were billed to Medicare 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 said 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 patients before their blood was sent to a laboratory for analysis. In his plea, Rodriguez admitted that he did order that patients at Midway receive medications designed to treat thrombocytopenia—even though the laboratory results had been reportedly falsified and the patients did not have the condition. Rodriguez also admitted that he caused more than $20 million in false claims that were submitted to Medicare at all of his clinics, including Midway.

Rodriguez's co defendants, who have already been sentenced for their roles at Midway and related clinics, are physician Carlos Garrido, 69, who was sentenced to 37 months in prison; medical assistant Gonzalo Nodarse, 38, who was sentenced to 78 months in prison; medical assistant Alexis Carrazana, 41, who was sentenced to 72 months in prison; and chemist Alexis Dagnesses, 44, who was sentenced to 90 months in prison. Rodriguez's co defendant Carmen del Cueto, a physician, is scheduled to be sentenced in September.

The case was investigated by the Department of Health and Human Services' Office of the Inspector General and the Federal Bureau of Investigation. The case was brought as part of the Medicare Fraud Strike Force, which has increased its activities in Miami.


Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at jsimmons@healthleadersmedia.com.

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