Insurance Fraud NEWS

Coalition Against Insurance Fraud

Doc lends signature to fake, repetitive claims in Miami area

July 16, 2017, Miami, FL — To use his Reflections Treatment Center in his plan to scam insurance money for substance abuse treatment, Kenneth Chatman needed a doctor. Friday, Miramar’s Joaquin Mendez pleaded guilty in federal court to being that doctor.

Mendez admitted to one count of conspiracy to commit health care fraud the day after a nationwide Medicare fraud bust reaffirmed South Florida's preeminence in the criminal genre and two months after Chatman got a 27-year sentence for running his game at faux sober homes in Broward and Palm Beach.

Mendez brought his medical license (issued February 2000) and signature to the fraud. As medical director of Reflections in Margate, Mendez theoretically would handle evaluation and care of patients. Instead, Mendez’s guilty plea admission statement says, Chatman, a man with no license, “dictated the type and frequency of different types of lab testing that would be performed based upon the kickbacks and bribes that he was receiving from different clinical laboratories.”

Mendez signed off on testing he knew to be repetitive and unnecessary, on testing he didn’t know to be necessary because he hadn’t examined the patient and even “signed off on hundreds of certificates of medical necessity for urine and saliva testing after the testing had actually been done, and in some cases, after the patients had been discharged from Reflections.”

Without Mendez’s authorization, Reflections couldn’t bill federal or private insurers. And this was checkbook approval.

“Defendant Mendez refused to sign certificates of medical necessity for urine and saliva drug testing and refused to review test results due to a financial dispute he had with Chatman,” Mendez’s admission statement says. “Chatman eventually paid Mendez, resolving the financial dispute, which resulted in Mendez electronically signing hundreds of test results without conducting any substantive review or using those results to direct treatment.”

Clearly, Mendez understood the financial worth of his approval. By federal statute, it’s maximum worth in time is 10 years in prison. He’ll be sentenced in September.

Source: Miami Herald

< Back to stories list