Insurance Fraud NEWS
Miami pharma owner guilty of $8.4M kickback scheme
October 09, 2018, Miami, FL
The owner of a Miami-area pharmacy pleaded guilty for his role in Medicare prescription fraud scheme involving approximately $8.4 million in fraudulent billings.
Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division; U.S. Attorney Ariana Fajardo Orshan for the Southern District of Florida; Special Agent in Charge Robert Lasky of the FBI’s Miami Field Office; Special Agent in Charge Shimon R. Richmond of the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG); Special Agent in Charge Brian Swain of the U.S. Secret Service (USSS), and Special Agent in Charge Adolphus P. Wright of the U.S. Drug Enforcement Administration (DEA) Miami Field Division made the announcement.
Antonio Perez Jr., 48, of Miami Beach, Florida, pleaded guilty today before U.S. District Judge Federico A. Moreno to one count of conspiracy to commit health care fraud.
According to admissions made in connection with his guilty plea, Perez Jr. was the owner of A.R.A. Medical Services Inc., which did business under the name Valles Pharmacy Discount (Valles Pharmacy). Perez Jr. pleaded guilty to agreeing to pay illegal health care kickbacks to Medicare beneficiaries in exchange for a promise from the beneficiaries to fill their prescriptions at Valles Pharmacy, and to allow Valles Pharmacy to submit claims to Medicare for prescription drugs that were not provided to the beneficiaries. Perez Jr. also admitted that he submitted claims to Medicare for expensive prescription medications that Valles Pharmacy never purchased, and were never provided to Medicare beneficiaries. According to admissions made in connection with Perez Jr.’s plea, during the course of the scheme, Valles Pharmacy Discount submitted over $32 million in claims to Medicare for prescription drugs, of which approximately $8.4 million was for medically unnessecary prescription drugs that Valles Pharmacy never purchased, and were never provided to Medicare beneficiaries. Perez Jr. also agreed to forfeit a property located on Collins Avenue in Miami Beach, as well as several bank accounts used to carry out the fraud.
The case was investigated by the FBI and HHS-OIG, and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office of the Southern District of Florida. The case was prosecuted by Trial Attorney Timothy P. Loper of the Criminal Division’s Fraud Section.
The Fraud Section leads the Medicare Fraud Strike Force, which is part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in 12 cities across the country, has charged nearly 4,000 defendants who have collectively billed the Medicare program for more than $14 billion. In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
Source: United States Department of Justice