By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On Friday, a Miami pharmacy owner charged in a Medicare fraud scheme, surrendered to U.S. authorities after hiding in Cuba for over two years. Sandy De La Fe, was charged in 2013 with unlawfully pocketing $2.8 million in taxpayer-funded Medicare payments through his former business Goldenway Pharmacy Discount.
False Claims for Prescription Drugs.
According to the indictment, De La Fe submitted false claims for prescription drugs by using Medicare beneficiaries’ ID numbers. He also forged doctors’ signatures for medication that was either unnecessary or not provided at all. The scheme ran between 2011 and 2013, and according to the U.S. Attorney, is hardly unique. The U.S. Attorney’s Office has increasingly made cases against South Florida Pharmacy offenders who steal from the Medicare Part D drug program. To read a previous blog I wrote on the fraud and abuse plaguing the Medicare Part D program, click here.
Goldenway Pharmacy Discount Scheme.
De La Fe is also charged with conspiring with his business associates Jose Teijeiro and Michael Gonzalez Cabral, to pay recruiters to bring in Medicare beneficiaries. Both business associates have already plead guilty to fraud charges and are serving nine-year and five-year jail sentences. De La Fe had his first court appearance on Monday, since turning himself in. The prosecutor in the case plans to recommend no bail, arguing the defendant is a flight risk. Click here to read a previous blog I wrote on a similar case of Medicare fraud.
Voluntary Surrender.
In the case of Medicare fraud and fugitives, an estimated 150 South Florida defendants are at large in Cuba, Mexico and other countries. Normally, fugitives are stopped on federal arrest warrants or upon trying to enter the United States. A defendant voluntarily surrendering is highly unusual in cases like this. Apparently, De La Fe didn’t like life on the lam, and sources say that he missed his young son whom he left behind in the states.
De la Fe purchased his own plane ticket to Miami International Airport, where U.S. Marshall’s apprehended him.
Is Cuba No Longer a Safe Haven for Medicare Thieves?
We have defended physicians and other health professionals who have had their Medicare numbers and identities stolen by those seeking to use them to submit false bills to Medicare. Often in such cases, at least here in Florida, the perpetrator of such crimes has fled with the illegal proceeds. We suspect, in many cases, that they have gone to Cuba. With the relaxation of the relationship between the U.S. and Cuba, this may mean that Cuba is no longer a safe haven for such criminals. It is yet to be seen whether Cuba is likely to allow the extradition of such criminals or cooperate with government officials in the return of stolen funds. However, such may well be the case.
Don’t Wait Until It’s Too Late; Consult with a Health Law Attorney Experienced in Medicare and Medicaid Issues Now.
The attorneys of The Health Law Firm represent healthcare providers in Medicare audits, ZPIC audits and RAC audits throughout Florida and across the U.S. They also represent physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals and other healthcare providers and institutions in Medicare and Medicaid investigations, audits, recovery actions and termination from the Medicare or Medicaid Program.
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Comments?
As a pharmacy owner, pharmacy employee or health care facility owner, what do you think of the increased effort to find fraud? Do you think all facilities, not just pharmacies, are under the microscope? Please leave any thoughtful comments below.
Sources:
“Miami Pharmacy Owner Charged in Medicare Fraud Scheme Returns After Hiding in Cuba.” AHLA. (January 14, 2016). Web.
Weaver, Jay. “Miami Medicare-fraud fugitive returns from Cuba.” Miami Herald. (January 14, 2016). Web.
About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.
KeyWords: Medicare fraud, Centers for Medicare and Medicaid Services (CMS), pharmacy, Florida pharmacy investigation, false claims, Office of Inspector General (OIG), Department of Health (DOH), U.S. Department of Health and Human Services (HHS), pharmacy raid, defense attorney, defense lawyer, pharmacist defense, Medicare fraud defense lawyer, Legal counsel for pharmacists, Goldenway Pharmacy Discount, Florida pharmacy defense attorney, Florida health care attorney, Florida health care lawyer
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