WASHINGTON – Jose Garcia, 55, was sentenced yesterday in U.S. District Court
in Miami to 57 months in prison for his participation in a Medicare
fraud scheme involving a Miami-area HIV clinic, the Departments of
Justice and Health and Human Services (HHS) announced.
U.S. District Judge Adalberto Jordan also ordered Garcia to serve three
years of supervised release and ordered him to pay, jointly and
severally with his co-conspirators, restitution of $7,992,391.
Garcia was indicted in 2008 and was a fugitive for nearly two years
before surrendering to FBI agents in May 2010. Garcia pleaded guilty in
August 2010 to one count of conspiracy to cause the submission of false
claims to the Medicare program and to pay health care kickbacks; and one
count of conspiracy to commit health care fraud.
According to court documents, Garcia operated Global Med-Care Corp.
Inc., a medical clinic in Miami that purported to specialize in treating
patients with HIV. Garcia, his co-defendant Nayda Freire and others
caused Global Med-Care to submit claims to the Medicare program for
expensive HIV medication that was medically unnecessary or never
provided. In return for a share of Global Med-Care’s profits, Garcia and
Freire agreed with their co-conspirators to oversee the staff necessary
to operate Global Med-Care; the Medicare patients whom Global billed to
the Medicare program; and the transportation for the patients. Garcia
admitted he knew that Global Med-Care would need to pay kickbacks to its
patients and that Global Med-Care could bill Medicare for HIV infusion
services three times a week, for up to three months, for each patient.
Garcia also admitted that from April 2003 through August 2003, Global
Med-Care submitted approximately $10.9 million in claims to the Medicare
program for HIV infusion services that were never provided and/or
medically unnecessary.
Freire pleaded guilty in August 2008 to one count of conspiracy to
defraud the Medicare program, and was sentenced by Judge Jordan on Nov.
12, 2008, to 30 months in prison.
Freire admitted that after payments from Medicare were made into the
bank accounts of Global Med-Care, she and others transferred
approximately $6 million of the fraud proceeds to sham management,
marketing and investment companies owned and operated by co-conspirators
Carlos, Luis and Jose Benitez. Carlos, Luis and Jose Benitez and Thomas
McKenzie were charged separately with health care fraud and other
related crimes in an indictment unsealed on June 11, 2008. According to
the separate indictment, these co-conspirators allegedly provided the
money and staff necessary to open Global Med-Care; the Medicare patients
whom the clinic would bill to the Medicare program; and transportation
for the HIV patients who visited the clinic. That indictment also
alleges that Carlos and Luis Benitez were the true owners of Global
Med-Care.
The three Benitez brothers and McKenzie were charged with participating
in the commission of approximately $109 million in HIV infusion fraud
and money laundering through Global Med-Care and 10 other HIV infusion
clinics. On Sept. 18, 2008, McKenzie pleaded guilty to one count of
conspiracy to commit health care fraud and one count of submitting false
claims to the Medicare program, and also admitted his role in a $119
million HIV infusion fraud scheme. McKenzie was sentenced by U.S.
District Judge Alan S. Gold on Dec. 18, 2008, to 14 years in prison in
connection with his role in the HIV infusion Medicare fraud scheme. In
addition to the prison sentence, McKenzie was ordered to pay $84 million
in restitution to the Medicare program. The Benitez brothers remain
fugitives. An indictment is merely an accusation and the Benitez
brothers remain innocent until proven guilty in a court of law.
The sentence was announced by Assistant Attorney General Lanny A.
Breuer of the Criminal Division; U.S. Attorney Wifredo A. Ferrer of the
Southern District of Florida; John V. Gillies, Special Agent-in-Charge
of the FBI’s Miami field office; and Special Agent-in-Charge Christopher
Dennis of the HHS Office of Inspector General (HHS-OIG), Office of
Investigations Miami office.
The case was prosecuted by Deputy Chief Hank Bond Walther and Trial
Attorney N. Nathan Dimock of the Criminal Division’s Fraud Section, and
was investigated by the FBI and HHS-OIG. The case was brought as part of
the Medicare Fraud Strike Force, supervised by the Criminal Division’s
Fraud Section and the U.S. Attorney’s Office for the Southern District
of Florida.
Since their inception in March 2007, Strike Force operations in seven
districts have obtained indictments of more than 825 individuals who
collectively have falsely billed the Medicare program for approximately
$2 billion. In addition, HHS’s Centers for Medicare and Medicaid
Services, working in conjunction with the HHS-OIG, are taking steps to
increase accountability and decrease the presence of fraudulent
providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to: www.stopmedicarefraud.gov.
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