In the first case, Angel Castillo Jr.'s eight durable medical equipment companies in Miami collectively submitted more than $48,000,000 in false claims in 2005 and 2006 using two medical billing companies. The companies never provided any Medicare patients with any type of equipment or service, says the U.S. Attorney's Office, and Mr. Castillo used a series of nominee owners to conceal his ownership of the companies. "After receiving more than $7 million in Medicare payments, Mr. Castillo laundered the proceeds of the scheme using friends, family and other associates, including various bank employees, to cash hundreds of checks," writes the attorney's office. "In some instances, Castillo?s associates needed duffel bags to carry the cash out of local banks." Mr. Castillo's co-defendants and defendants in cases related to this scheme have all pleaded guilty to related healthcare fraud and money laundering offenses.
In the second case, Ana Caos, MD, Maria T. Hernandez, Marta F. Jimenez and Maivi Rodriguez were found guilty on all charged counts, including conspiracy to defraud the U.S. government, to cause the submission of false claims to Medicare, and to solicit and receive kickbacks; and conspiracy to commit health care fraud. All but Dr. Caos were also found guilty on six counts of receiving kickbacks in exchange for referring Medicare patients.
According to the Justice Department, more than 60 patients controlled by Ms. Hernandez, Ms. Jimenez and Ms. Rodriguez via their companies were falsely diagnosed with chronic obstructive pulmonary disease and prescribed unnecessary aerosol medications, including compounded medications delivered by Miami-area pharmacies, by Dr. Caos. Patients testified that they were paid cash kickbacks to accept delivery of the unnecessary medication and medical equipment that was billed to Medicare; former physician Pedro Cuni, who is serving time in prison for Medicare fraud, testified that he was paid $50 apiece to write prescriptions for the patients controlled by these defendants. Further, "testimony revealed that one of the men making the medicine at the pharmacies, was unlicensed and had been trained as an auto mechanic."
Medicare was billed $487,783 by complicit pharmacies for the prescriptions for these patients; in exchange for bringing the prescriptions to the pharmacies, the defendants received approximately $150,000 from the pharmacy owners, who have also been sentenced to time in federal prison, says the DOJ. And between December 1997 and January 2007, the defendants directly billed Medicare more than $1.6 million for durable medical equipment for these same patients.