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Medicare Fruad Ring Busted

June 24, 2009

Federal agents busted a fraudulent medicare ring that stretched across five states. The Miami based ring was scheming to submit 100 million dollars in false claims for HIV therapy. The organization consisted of eight people and operated through empty store fronts and post office boxes.

U.S. Attorney Jeffrey Sloman reported to the Miami Herald:
“These defendants have taken health care fraud to a new level, the breadth and scope of the scheme is different than what we’ve ever seen before.”

The Obama administration has made a point to stop insurance fraud as part of an overall plan to reform health insurance. Since 2005, the US attorney’s office has already charged about 800 suspects for filing 2 billion in false claims.

The Miami Herald also released that Michel De Jesus Huarte, 38, is charged with operating six Miami-Dade clinics that submitted $50.2 million in bogus claims for infusion therapy to treat patients with cancer, HIV, AIDS, chronic pain and varicose veins.

Huarte recruited people from Cuba to run the fake store fronts. It is believed this was planned so that the others could flee back to Cuba if charges were ever brought up. Orlin Tamayo Quinonez, 35, and Juan Carralero, 56, and Madelin Barbara Machado, 35, were among those recruited but they are suspected of having fled to Cuba.

Operations expanded to all five states when Huarte teamed up with Ramon Fonseca. The two opened up 30 additional clinics and targeting private insurance companies that operated under the medicare advantage plan. Four others have been taken into custody as suspects in the operations.

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