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Editor: Mike Bothwell
Profession: Qui Tam Attorney

Category: Settlements and Verdicts

On May 30, 2008, the Criminal Division of the Department of Justice and the Attorney General's office released a statement indicating that three doctors and six other individuals that have been charged in four different indictments for involvement in a $56 million HIV infusion fraud scheme.

Between August 2002 and March 2004, Dr. Ronald Harris and Enrique Gonzalez allegedly submitted false claims to Medicare. The fraudulent claims totaled about $24.5 million for HIV infusion services that Physicians Med-Care and Physicians Health Med-Care allegedly provided. Harris allegedly ordered unnecessary tests and authorized treatment to Medicare beneficiaries. Authorities stated that Gonzalez bribed Medicare beneficiaries to sign up for treatment they did not need, and would not receive. If convicted, both Harris and Gonzalez could serve a maximum of 60 years in prison and forfeiture of assets.

In a similar indictment, between May 2003 and January 2004, Juan Carlos Castaneda, Dilcia Marinez and Luis Frias are alleged to have conspired to submit $14 million of fraudulent claims to Medicare for services provided at G&S Medical Clinic for HIV infusions. Kickbacks allegedly were given to Medicare beneficiaries to falsely sign documentation that they received treatment. Marketing companies owned by co-conspirators then were allegedly used to launder the funds from the medical clinic. Castaneda could face up to 90 years in prison if convicted. Marinez faces 140 years and Frias could receive up to 85 years in prison.

A third indictment accuses Jose Garcia and Nayda Freire of submitting about $10.9 million in fraudulent claims to Medicare between April 2003 and November 2003. Garcia and Freire allegedly hired physicians and physician assistants at Global Med-Care where they would bribe Medicare beneficiaries to sign fraudulently documentation stating they received HIV infusion treatment. If convicted, Garcia faces a maximum of 85 years in prison and Freire could receive a maximum of 65 years if convicted of all charges.

Between November 2002 and April 2004, Dr. Carlos Contreras and Dr. Ramon Pichardo submitted about $6.8 million in fraudulent claims to Medicare for HIV infusion services which were allegedly administered at C.N.C. Medical Corp. Both doctors and co-conspirators ordered unnecessary tests for patients who would be given kickbacks for signing forms for treatment they never received. Drs. Contreras and Pichardo used marketing companies owned by their co-conspirators to launder the funds from C.N.C. Medical Corp. If convicted, Contreras faces a maximum of 70 years and in prison and Pichardo faces a maximum of 55 years.