The team, here at Allegiant Experts, is proud to operate in the beautiful state of Florida. As we mentioned in our blog from two weeks ago, we make this no secret. And why would we? Who doesn’t love Florida? We will say, however, that if there’s anything to dislike about the Sunshine State, it’s the medical doctors who involve themselves in health insurance fraud schemes.
Of course, this type of fraud is not at all exclusive to Florida. Our blog has covered many a story emanating from all over this great country of ours. However, we can’t help but pay extra special attention to stories that literally hit close to home. A recent report from the United States Department of Justice about Dr. Miguel Burgos is one such story. The Orlando-based doctor was recently sentenced to no less than 64 months in prison and two years supervised release for his role in a $13.7 million Medicare fraud conspiracy.
According the report, the 60 year-old physician colluded with an infusion clinic owner in a scam to bilk funds from Medicare for expensive infusion-therapy drugs. These drugs, says the report, were never purchased, never provided and not even medically necessary. The infusion clinic owner, 40 year-old Yosbel Marimon, was also sentenced to 90 months in prison and two years supervised release.
In addition, the pair was ordered by the judge to pay $9.8 million in restitution and to forfeit the same amount. Of the $13.7 million that Burgos and Marimon billed the insurance providers, $9.8 million were paid on fraudulent claims. “As part of his plea, Marimon also consented to the forfeiture of real property valued at approximately $1.7 million,” reveals the report, “Burgos and Marimon each pleaded guilty to one count of conspiracy to commit health care fraud: Burgos on February 9, Marimon on February 16.”
Between July 2008 and September 2011, Burgos was the medical director of four infusion clinics in Orlando. Marimon owned one of the four clinics. Together, the two billed Medicare as well as private insurance companies for expensive infusion therapy medications that they never actually administered to any patients. These medications included those of the anticancer chemotherapeutic variety.
As well, Burgos and Marimon billed Medicare and private insurance companies for physical therapy sessions at their clinics. Not only was no physical therapy offered to patients, but there were no licensed physical therapists even working at any of the clinics. For the record, none of the above revelations were required to be proven in court as the defendants admitted to all of them.
For over 15 years, the Allegiant Experts team has come across many a case like the one described in today’s blog. Our clinical experts have a lot of experience supporting both attorneys and special investigation units in their cases against those who commit health care fraud. Our consultants act as specialized members of the litigation or investigation team and their professional contributions are often critical to achieving fair and just outcomes for all parties.
For more information about how we may be able to help your health care fraud case, please don’t hesitate to call us at 407-217-5831 or email us at info@allegiantexperts.com.