DOJ Obtains 14-Year Terms for Two in Separate Health Care Fraud Schemes
By David Stout | February 27, 2013 4:01 pm

The Department of Justice has just obtained 14-year prison sentences against the owner of mental health facilities in Florida and North Carolina and a Miami discount-pharmacy operator in separate cases that prosecutors said underscored the DOJ’s commitment to rooting out health care fraud.

Armando Gonzalez, 50, of Miami, who ran the mental health facilities, was sentenced on Monday in Miami by U.S. Judge Cecilia M. Altonaga of the Southern District of Florida. In addition to his prison term, he was ordered to pay more than $28 million in restitution, to be satisfied in part by seizure of his mansion in Hendersonville, N.C.

Gonzalez, who pleaded guilty in December to one count of conspiracy to commit health care fraud and one county of conspiracy to launder money, ran a scheme in which he traveled back and forth from Florida to North Carolina, recruiting patients through kickbacks, then billing Medicare for treatment that could not help the people, or sometimes treatment that was not even provided. Gonzales was one of 107 arrested in a DOJĀ  fraud sweep last May (see Main Justice’s report).

Prosecutors said Gonzalez’s scheme went on for the better part of a decade and resulted in Medicare and the Florida Medicaid programs being billed for some $63 million and paying out more than $28 million.

The Miami pharmacy owner, Jose Carlos Morales, 55, was sentenced in Miami on Monday by Judge Joan A. Lenard, also of the Southern District. He was also fined $100,000, and a hearing was set for April 29 to determine the amount of restitution he must pay.

Prosecutors said Morales defrauded Medicare and Florida Medicaid out of some $23 million through his three discount drug stores by paying kickbacks to obtain information on beneficiaries, data that he sued to submit claims. In some instances, his drivers picked up unused drugs from assisted-living facilities, put them back into bill bottles, then billed Medicare and Medicaid again, prosecutors said.

On Wednesday, the owners and operators of two Miami health care facilities were sentenced to terms of nine years and just over four years for a fraud scheme that billed Medicare for some $48 million for home health services that were not necessary or were not even provided. Medicare paid out about $33 million for these claims, prosecutors said.

Judge Frederico A. Moreno of the Southern District sentenced Rogelio Rodriguez, 43, to nine years and ordered him to pay $33 million restitution. Raymond Aday, 48, was sentenced to 51 months in prison and ordered to make restitution of $2.1 million. The defendants, who live in the Miami area, were also fined $100,000 each. Each had pleaded guilty to oneĀ  count of conspiracy to commit health care fraud.

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