Florid Man Strikes Again–Government Asks for Life Sentence for Florida Man in $187M Medicare Fraud Case

George IndestBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm

On August 12, 2023, federal prosecutors recommended a life sentence for the Florida ex-CEO of a laboratory company who had been found guilty of fraudulently billing Medicare over one hundred million dollars. At the December 2022 trial of the Florida man, the jury convicted the Florida Man of all ten counts against him, including health care fraud, payment of kickbacks, and conspiracy to commit money laundering. He was ordered to pay $187 million in restitution.

I have to say it. They need to lock up that Florida man once and for all! I see his wanton actions all over Florida, reported time and time again. Now that Tim Dorsey is deceased (bless his Florida soul) we don’t have a character like Serge Storms to go around and assassinate (at least literarily) such evildoers as Florida man. Will this mean a big upsurge in crimes committed by Florida man?

Specifics of the Health Care Fraud Committed.

From 2016 to 2019, the ex-CEO operated with co-conspirators out of Palm Beach County to conduct a scheme that spanned the entire country. The Florida Man was the CEO of the laboratory company and the architect of the fraudulent scheme. The ex-CEO oversaw and approved every step of the Medicare fraud process.

The Florida Man recruited and bribed patient brokers, directed the use of deceptive marketing techniques, encouraged the use of telemedicine companies that gave approval without consideration, and took measures to conceal the fraud and make it seem legitimate.

The ex-CEO bribed patient brokers, telemedicine companies, and telemarketing companies to contact Medicare beneficiaries and pressure them into taking medically unnecessary genetic tests through his laboratory company.

I would find it hard to believe that such willful and wanton illegal acts occur in the great state of Florida, except that I get about ten phone calls a day from these people trying to hook me into their phony schemes. Well, after this conviction, maybe I’ll only be getting nine phone calls a day from them (unless they allow Florida man unlimited phone calls for such purposes from his prison cell; and since this is Florida, they may well do that!).

He also instructed co-conspirators to go to nursing homes, bingo halls, adult day care facilities, and poor communities in the Atlanta area to pressure Medicare beneficiaries into taking the genetic test.

A single genetic test billed to Medicare could earn the ex-CEO $9,000. In three years, the lab billed Medicare $463 million, of which $187 million was paid out. The Florida Man personally earned $21 million which he spent on luxury purchases, like a Ferrari.

Effects of the Fraud.

The Florida Man exposed Medicare to a fraud where it paid $187 million for medically unnecessary genetic tests; an exorbitant loss. The scheme also confused patients and confounded doctors.

One victim of the fraud was led to believe that the genetic test would tell her if her cancer would return. She took the test and, since it was negative for the mutated gene, she was wrongly led to believe her cancer would not return. Her cancer did return.

Another victim of the fraud tested positive for a gene mutation that they did not actually have. This made their primary care doctor re-bill the genetic test to Medicare to confirm the results. This test came back negative for the gene mutation. The lab’s test was faulty and gave an inaccurate result.

The federal prosecutors argued that the Florida Man preyed on cancer survivors, elderly patients, and people afraid of getting cancer to steal hundreds of millions of dollars from a social safety net.

Sentencing Recommendation.

The government recommended that the Florida Man’s sentencing be considered in decades, rather than months or years, due to the seriousness of the crime and the man’s unwillingness to accept responsibility or show remorse.

During the trial and in post-conviction pleadings, the ex-CEO continuously placed blame on his lawyers, his employees, and the lab directors. He claimed that the kickbacks and bribes were contracts reviewed and negotiated by lawyers and the genetic tests were appropriate and properly signed by physicians.

The government also recommended that the restitution be increased because, even though only $187 million was paid out by Medicare, the laboratory company billed Medicare $463 million. Prosecutors argued that the restitution should be calculated based on the intended loss of $463 million.

The federal prosecutors claimed that since this is one of the largest genetic testing scheme ever brought to trial, the sentencing must act as a deterrent. The prosecutors argued that a life sentence for the Florida Man would reflect the seriousness of the Medicare fraud and deter others from conducting similar healthcare fraud schemes.

Contact Health Law Attorneys Experienced Health Care Fraud and Anti-Kickback Statute Violations.

The attorneys of The Health Law Firm represent healthcare providers in cases of medical billing fraud, overbilling, Medicare audits, Integrity Contractor audits RAC audits, and False Claims Act cases throughout Florida and across the United States. Our attorneys 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.

To contact The Health Law Firm, please call (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

About the Authors: 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. Hartley Brooks is a law clerk with the health law firm. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

Attorney Positions with The Health Law Firm. The Health Law Firm is always looking for qualified attorneys interested in health law practice. Its main office is in the Orlando, Florida, area. If you are a member of The Florida Bar and are interested, forward a cover letter and your resume to: [email protected] or fax to: (407) 331-3030.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999. Copyright © 2023 The Health Law Firm. All rights reserved.

Florid Man Strikes Again: Government Asks for Life Sentence for Florida Man in $187M Medicare Fraud Case

George IndestBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm

On August 12, 2023, federal prosecutors recommended a life sentence for the Florida ex-CEO of a laboratory company who had been found guilty of fraudulently billing Medicare over one hundred million dollars. At the December 2022 trial of the Florida man, the jury convicted the Florida Man of all ten counts against him, including health care fraud, payment of kickbacks, and conspiracy to commit money laundering. He was ordered to pay $187 million in restitution.

I have to say it. They need to lock up that Florida man once and for all! I see his wanton actions all over Florida, reported time and time again. Now that Tim Dorsey is deceased (bless his Florida soul) we don’t have a character like Serge Storms to go around and assassinate (at least literarily) such evildoers as Florida man. Will this mean a big upsurge in crimes committed by Florida man?

Specifics of the Health Care Fraud Committed.

From 2016 to 2019, the ex-CEO operated with co-conspirators out of Palm Beach County to conduct a scheme that spanned the entire country. The Florida Man was the CEO of the laboratory company and the architect of the fraudulent scheme. The ex-CEO oversaw and approved every step of the Medicare fraud process.

The Florida Man recruited and bribed patient brokers, directed the use of deceptive marketing techniques, encouraged the use of telemedicine companies that gave approval without consideration, and took measures to conceal the fraud and make it seem legitimate.

The ex-CEO bribed patient brokers, telemedicine companies, and telemarketing companies to contact Medicare beneficiaries and pressure them into taking medically unnecessary genetic tests through his laboratory company.

I would find it hard to believe that such willful and wanton illegal acts occur in the great state of Florida, except that I get about ten phone calls a day from these people trying to hook me into their phony schemes. Well, after this conviction, maybe I’ll only be getting nine phone calls a day from them (unless they allow Florida man unlimited phone calls for such purposes from his prison cell; and since this is Florida, they may well do that!).

He also instructed co-conspirators to go to nursing homes, bingo halls, adult day care facilities, and poor communities in the Atlanta area to pressure Medicare beneficiaries into taking the genetic test.

A single genetic test billed to Medicare could earn the ex-CEO $9,000. In three years, the lab billed Medicare $463 million, of which $187 million was paid out. The Florida Man personally earned $21 million which he spent on luxury purchases, like a Ferrari.

Effects of the Fraud.

The Florida Man exposed Medicare to a fraud where it paid $187 million for medically unnecessary genetic tests; an exorbitant loss. The scheme also confused patients and confounded doctors.

One victim of the fraud was led to believe that the genetic test would tell her if her cancer would return. She took the test and, since it was negative for the mutated gene, she was wrongly led to believe her cancer would not return. Her cancer did return.

Another victim of the fraud tested positive for a gene mutation that they did not actually have. This made their primary care doctor re-bill the genetic test to Medicare to confirm the results. This test came back negative for the gene mutation. The lab’s test was faulty and gave an inaccurate result.

The federal prosecutors argued that the Florida Man preyed on cancer survivors, elderly patients, and people afraid of getting cancer to steal hundreds of millions of dollars from a social safety net.

Sentencing Recommendation.

The government recommended that the Florida Man’s sentencing be considered in decades, rather than months or years, due to the seriousness of the crime and the man’s unwillingness to accept responsibility or show remorse.

During the trial and in post-conviction pleadings, the ex-CEO continuously placed blame on his lawyers, his employees, and the lab directors. He claimed that the kickbacks and bribes were contracts reviewed and negotiated by lawyers and the genetic tests were appropriate and properly signed by physicians.

The government also recommended that the restitution be increased because, even though only $187 million was paid out by Medicare, the laboratory company billed Medicare $463 million. Prosecutors argued that the restitution should be calculated based on the intended loss of $463 million.

The federal prosecutors claimed that since this is one of the largest genetic testing scheme ever brought to trial, the sentencing must act as a deterrent. The prosecutors argued that a life sentence for the Florida Man would reflect the seriousness of the Medicare fraud and deter others from conducting similar healthcare fraud schemes.

Contact Health Law Attorneys Experienced Health Care Fraud and Anti-Kickback Statute Violations.

The attorneys of The Health Law Firm represent healthcare providers in cases of medical billing fraud, overbilling, Medicare audits, Integrity Contractor audits RAC audits, and False Claims Act cases throughout Florida and across the United States. Our attorneys 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.

To contact The Health Law Firm, please call (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

About the Authors: 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. Hartley Brooks is a law clerk with the health law firm. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

Attorney Positions with The Health Law Firm. The Health Law Firm is always looking for qualified attorneys interested in health law practice. Its main office is in the Orlando, Florida, area. If you are a member of The Florida Bar and are interested, forward a cover letter and your resume to: [email protected] or fax to: (407) 331-3030.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999. Copyright © 2023 The Health Law Firm. All rights reserved.

Florid Man Strikes Again–Government Asks for Life Sentence for Florida Man in $187M Medicare Fraud Case

George IndestBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm

On August 12, 2023, federal prosecutors recommended a life sentence for the Florida ex-CEO of a laboratory company who had been found guilty of fraudulently billing Medicare over one hundred million dollars. At the December 2022 trial of the Florida man, the jury convicted the Florida Man of all ten counts against him, including health care fraud, payment of kickbacks, and conspiracy to commit money laundering. He was ordered to pay $187 million in restitution.

I have to say it. They need to lock up that Florida man once and for all! I see his wanton actions all over Florida, reported time and time again. Now that Tim Dorsey is deceased (bless his Florida soul) we don’t have a character like Serge Storms to go around and assassinate (at least literarily) such evildoers as Florida man. Will this mean a big upsurge in crimes committed by Florida man?

Specifics of the Health Care Fraud Committed.

From 2016 to 2019, the ex-CEO operated with co-conspirators out of Palm Beach County to conduct a scheme that spanned the entire country. The Florida Man was the CEO of the laboratory company and the architect of the fraudulent scheme. The ex-CEO oversaw and approved every step of the Medicare fraud process.

The Florida Man recruited and bribed patient brokers, directed the use of deceptive marketing techniques, encouraged the use of telemedicine companies that gave approval without consideration, and took measures to conceal the fraud and make it seem legitimate.

The ex-CEO bribed patient brokers, telemedicine companies, and telemarketing companies to contact Medicare beneficiaries and pressure them into taking medically unnecessary genetic tests through his laboratory company.

I would find it hard to believe that such willful and wanton illegal acts occur in the great state of Florida, except that I get about ten phone calls a day from these people trying to hook me into their phony schemes. Well, after this conviction, maybe I’ll only be getting nine phone calls a day from them (unless they allow Florida man unlimited phone calls for such purposes from his prison cell; and since this is Florida, they may well do that!).

He also instructed co-conspirators to go to nursing homes, bingo halls, adult day care facilities, and poor communities in the Atlanta area to pressure Medicare beneficiaries into taking the genetic test.

A single genetic test billed to Medicare could earn the ex-CEO $9,000. In three years, the lab billed Medicare $463 million, of which $187 million was paid out. The Florida Man personally earned $21 million which he spent on luxury purchases, like a Ferrari.

Effects of the Fraud.

The Florida Man exposed Medicare to a fraud where it paid $187 million for medically unnecessary genetic tests; an exorbitant loss. The scheme also confused patients and confounded doctors.

One victim of the fraud was led to believe that the genetic test would tell her if her cancer would return. She took the test and, since it was negative for the mutated gene, she was wrongly led to believe her cancer would not return. Her cancer did return.

Another victim of the fraud tested positive for a gene mutation that they did not actually have. This made their primary care doctor re-bill the genetic test to Medicare to confirm the results. This test came back negative for the gene mutation. The lab’s test was faulty and gave an inaccurate result.

The federal prosecutors argued that the Florida Man preyed on cancer survivors, elderly patients, and people afraid of getting cancer to steal hundreds of millions of dollars from a social safety net.

Sentencing Recommendation.

The government recommended that the Florida Man’s sentencing be considered in decades, rather than months or years, due to the seriousness of the crime and the man’s unwillingness to accept responsibility or show remorse.

During the trial and in post-conviction pleadings, the ex-CEO continuously placed blame on his lawyers, his employees, and the lab directors. He claimed that the kickbacks and bribes were contracts reviewed and negotiated by lawyers and the genetic tests were appropriate and properly signed by physicians.

The government also recommended that the restitution be increased because, even though only $187 million was paid out by Medicare, the laboratory company billed Medicare $463 million. Prosecutors argued that the restitution should be calculated based on the intended loss of $463 million.

The federal prosecutors claimed that since this is one of the largest genetic testing scheme ever brought to trial, the sentencing must act as a deterrent. The prosecutors argued that a life sentence for the Florida Man would reflect the seriousness of the Medicare fraud and deter others from conducting similar healthcare fraud schemes.

Contact Health Law Attorneys Experienced Health Care Fraud and Anti-Kickback Statute Violations.

The attorneys of The Health Law Firm represent healthcare providers in cases of medical billing fraud, overbilling, Medicare audits, Integrity Contractor audits RAC audits, and False Claims Act cases throughout Florida and across the United States. Our attorneys 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.

To contact The Health Law Firm, please call (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

About the Authors: 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. Hartley Brooks is a law clerk with the health law firm. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

Attorney Positions with The Health Law Firm. The Health Law Firm is always looking for qualified attorneys interested in health law practice. Its main office is in the Orlando, Florida, area. If you are a member of The Florida Bar and are interested, forward a cover letter and your resume to: [email protected] or fax to: (407) 331-3030.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999. Copyright © 2023 The Health Law Firm. All rights reserved.

Miami, Florida Man Gets 15 Years in Prison for HIV Drug Fraud Scheme;  $230 Million Lost to Fraud

author headshot standing in dark suit with arms crossedBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On June 15, 2023, a United States District Judge sentenced a Florida man to 15 years in prison for his role in an HIV prescription drug fraud scheme that amassed more than $230 million in two years.  The defendant was initially indicted on June 17, 2022, and charged with six counts of conspiracy and money laundering.  Unlike most of the fraud convictions we report on, this one was directed against the U.S. Food and Drug Administration (FDA) and involved adulterating and misbranding drugs.  The defendant pled guilty to only two counts: conspiracy to defraud the United States and conspiracy to commit money laundering.  Click here to view the press release from the U.S. Attorney’s Office, Southern District of Florida, to learn more about the arrest.

The Charges: Adulterated and Misbranded HIV Medications.

Prescription drug diversion is when prescription drugs are removed from regulated distribution channels and reintroduced into the wholesale market or otherwise illegally distributed.  These drugs can be acquired through theft, fraud, or patients who were prescribed the medication and intentionally did not consume them.
In this case, U.S. vs. Lazaro Hernandez,  the defendant would obtain prescribed drugs illegally, repackage them, falsify the documentation, and resell them to coconspirators through conspiracy wholesalers. To successfully divert the prescription medications, they got wholesale drug distributor licenses for LLC’s in Florida, New Jersey, Connecticut, and New York. These conspiracy wholesalers would purchase the diverted, adulterated, and misbranded drugs and documentation and sell them to pharmacies.
Adulteration occurs when any substance is added to or substituted, in part or in whole, or mixed with an approved drug.  Misbranding of a drug occurs when someone places a label on it that is false or misleading in any way, as defined in Title 21 U.S. Code sections 351(d) and 352 (a)(1).  In this case, the pharmacies billed health care benefit programs and dispensed adulterated and misbranded drugs to patients.  The pharmacies paid $232,800,000 for the diverted drugs between April 2019 and at least October 2021.

The six counts that the defendant was initially charged with include conspiracy to introduce adulterated and misbranded drugs and to defraud the United States, conspiracy to traffic pre-retail medical products with false documentation, conspiracy to commit money laundering, and three counts of money laundering.  The false documentation and money laundering charges were later dropped in the plea deal.

The Sentencing.

The government recommended a sentence of 188 to 235 months, which aligns with the defendant’s criminal history and total offense level (calculated in accordance with federal statutes and regulations), while the defense argued for a lesser amount of time due to the allegedly “secondary” role the defendant played in the fraud.  The judge sentenced the defendant to 180 months. Also included in the sentence was a forfeiture of all proceeds from the scam and restitution in an amount that has yet to be determined.

This lower-than-recommended prison sentence came after the defendant spoke about his gambling addiction, which allegedly led him to participate in the fraud. Also, two of his 47 character references addressed the court in person.  The judge was swayed to give him a lower sentence as a result. View the indictment in the case in full here.

Contact Health Law Attorneys Experienced with Investigations of Health Professionals and Providers.

The attorneys of The Health Law Firm provide legal representation to pharmacists, pharmacy facilities, physicians, nurse practitioners, CRNAs, dentists, psychologists, mental health professionals, nurses, and other health providers in Department of Health (DOH) investigations and hearings, Drug Enforcement Administration (DEA) investigations, audits and hearings, Food and Drug Administration (FDA) investigations and hearings, FBI investigations, Medicare/Medicaid investigations, audits and hearings, and many other actions involving defense of health professionals and providers.

To contact The Health Law Firm, please call (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Minsky, David. “Fla. Man Sentenced To 15 Years In Prison Over HIV Drug Fraud.” Law360. (June 16, 2023). Web.

Becker, Zoey. “In fraud case targeting HIV meds, Florida man gets 15 years in prison.” FiercePharma. (June 21, 2023). 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 Avenue, Suite 1000, Altamonte Springs, FL 32714.  Phone:  (407) 331-6620;  Toll-Free: (888) 331-6620.

Current Open Positions with The Health Law Firm.  The Health Law Firm always seeks qualified individuals interested in health law.  Its main office is in the Orlando, Florida, area.  If you are a current member of The Florida Bar or a qualified professional who is interested, please forward a cover letter and resume to:  [email protected] or fax them to (407) 331-3030.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2023 The Health Law Firm. All rights reserved.
By |2023-06-26T11:30:16-04:00August 22, 2023|Categories: Mental Health Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Florida Man Sentenced to 15 Years in Prison for HIV Drug Fraud Scheme;  $230 Million Lost to Fraud

author headshot standing in dark suit with arms crossedBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On June 15, 2023, a United States District Judge sentenced a Florida man to 15 years in prison for his role in an HIV prescription drug fraud scheme that amassed more than $230 million in two years.  The defendant was initially indicted on June 17, 2022, and charged with six counts of conspiracy and money laundering.  Unlike most of the fraud convictions we report on, this one was directed against the U.S. Food and Drug Administration (FDA) and involved adulterating and misbranding drugs.  The defendant pled guilty to only two counts: conspiracy to defraud the United States and conspiracy to commit money laundering.  Click here to view the press release from the U.S. Attorney’s Office, Southern District of Florida, to learn more about the arrest.


The Charges: Adulterated and Misbranded HIV Medications.

Prescription drug diversion is when prescription drugs are removed from regulated distribution channels and reintroduced into the wholesale market or otherwise illegally distributed.  These drugs can be acquired through theft, fraud, or patients who were prescribed the medication and intentionally did not consume them.
In this case, U.S. vs. Lazaro Hernandez,  the defendant would obtain prescribed drugs illegally, repackage them, falsify the documentation, and resell them to coconspirators through conspiracy wholesalers. To successfully divert the prescription medications, they got wholesale drug distributor licenses for LLC’s in Florida, New Jersey, Connecticut, and New York. These conspiracy wholesalers would purchase the diverted, adulterated, and misbranded drugs and documentation and sell them to pharmacies.
Adulteration occurs when any substance is added to or substituted, in part or in whole, or mixed with an approved drug.  Misbranding of a drug occurs when someone places a label on it that is false or misleading in any way, as defined in Title 21 U.S. Code sections 351(d) and 352 (a)(1).  In this case, the pharmacies billed health care benefit programs and dispensed adulterated and misbranded drugs to patients.  The pharmacies paid $232,800,000 for the diverted drugs between April 2019 and at least October 2021.

The six counts that the defendant was initially charged with include conspiracy to introduce adulterated and misbranded drugs and to defraud the United States, conspiracy to traffic pre-retail medical products with false documentation, conspiracy to commit money laundering, and three counts of money laundering.  The false documentation and money laundering charges were later dropped in the plea deal.

The Sentencing.

The government recommended a sentence of 188 to 235 months, which aligns with the defendant’s criminal history and total offense level (calculated in accordance with federal statutes and regulations), while the defense argued for a lesser amount of time due to the allegedly “secondary” role the defendant played in the fraud.  The judge sentenced the defendant to 180 months. Also included in the sentence was a forfeiture of all proceeds from the scam and restitution in an amount that has yet to be determined.

This lower-than-recommended prison sentence came after the defendant spoke about his gambling addiction, which allegedly led him to participate in the fraud. Also, two of his 47 character references addressed the court in person.  The judge was swayed to give him a lower sentence as a result. View the indictment in the case in full here.

Contact Health Law Attorneys Experienced with Investigations of Health Professionals and Providers.

The attorneys of The Health Law Firm provide legal representation to pharmacists, pharmacy facilities, physicians, nurse practitioners, CRNAs, dentists, psychologists, mental health professionals, nurses, and other health providers in Department of Health (DOH) investigations and hearings, Drug Enforcement Administration (DEA) investigations, audits and hearings, Food and Drug Administration (FDA) investigations and hearings, FBI investigations, Medicare/Medicaid investigations, audits and hearings, and many other actions involving defense of health professionals and providers.

To contact The Health Law Firm, please call (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Minsky, David. “Fla. Man Sentenced To 15 Years In Prison Over HIV Drug Fraud.” Law360. (June 16, 2023). Web.

Becker, Zoey. “In fraud case targeting HIV meds, Florida man gets 15 years in prison.” FiercePharma. (June 21, 2023). 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 Avenue, Suite 1000, Altamonte Springs, FL 32714.  Phone:  (407) 331-6620;  Toll-Free: (888) 331-6620.

Current Open Positions with The Health Law Firm.  The Health Law Firm always seeks qualified individuals interested in health law.  Its main office is in the Orlando, Florida, area.  If you are a current member of The Florida Bar or a qualified professional who is interested, please forward a cover letter and resume to:  [email protected] or fax them to (407) 331-3030.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2023 The Health Law Firm. All rights reserved.
By |2023-06-26T11:23:47-04:00August 8, 2023|Categories: Nursing Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Miami Man Gets 15 Years in Prison for HIV Drug Fraud Scheme;  $230 Million Lost to Fraud

author headshot standing in dark suit with arms crossedBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On June 15, 2023, a United States District Judge sentenced a Florida man to 15 years in prison for his role in an HIV prescription drug fraud scheme that amassed more than $230 million in two years.  The defendant was initially indicted on June 17, 2022, and charged with six counts of conspiracy and money laundering.  Unlike most of the fraud convictions we report on, this one was directed against the U.S. Food and Drug Administration (FDA) and involved adulterating and misbranding drugs.  The defendant pled guilty to only two counts: conspiracy to defraud the United States and conspiracy to commit money laundering.  Click here to view the press release from the U.S. Attorney’s Office, Southern District of Florida, to learn more about the arrest

The Charges: Adulterated and Misbranded HIV Medications.

Prescription drug diversion is when prescription drugs are removed from regulated distribution channels and reintroduced into the wholesale market or otherwise illegally distributed.  These drugs can be acquired through theft, fraud, or patients who were prescribed the medication and intentionally did not consume them.
In this case, U.S. vs. Lazaro Hernandez,  the defendant would obtain prescribed drugs illegally, repackage them, falsify the documentation, and resell them to coconspirators through conspiracy wholesalers. To successfully divert the prescription medications, they got wholesale drug distributor licenses for LLC’s in Florida, New Jersey, Connecticut, and New York. These conspiracy wholesalers would purchase the diverted, adulterated, and misbranded drugs and documentation and sell them to pharmacies.
Adulteration occurs when any substance is added to or substituted, in part or in whole, or mixed with an approved drug.  Misbranding of a drug occurs when someone places a label on it that is false or misleading in any way, as defined in Title 21 U.S. Code sections 351(d) and 352 (a)(1).  In this case, the pharmacies billed health care benefit programs and dispensed adulterated and misbranded drugs to patients.  The pharmacies paid $232,800,000 for the diverted drugs between April 2019 and at least October 2021.

The six counts that the defendant was initially charged with include conspiracy to introduce adulterated and misbranded drugs and to defraud the United States, conspiracy to traffic pre-retail medical products with false documentation, conspiracy to commit money laundering, and three counts of money laundering.  The false documentation and money laundering charges were later dropped in the plea deal.

The Sentencing.

The government recommended a sentence of 188 to 235 months, which aligns with the defendant’s criminal history and total offense level (calculated in accordance with federal statutes and regulations), while the defense argued for a lesser amount of time due to the allegedly “secondary” role the defendant played in the fraud.  The judge sentenced the defendant to 180 months. Also included in the sentence was a forfeiture of all proceeds from the scam and restitution in an amount that has yet to be determined.

This lower-than-recommended prison sentence came after the defendant spoke about his gambling addiction, which allegedly led him to participate in the fraud. Also, two of his 47 character references addressed the court in person.  The judge was swayed to give him a lower sentence as a result. View the indictment in the case in full here.

Contact Health Law Attorneys Experienced with Investigations of Health Professionals and Providers.

The attorneys of The Health Law Firm provide legal representation to pharmacists, pharmacy facilities, physicians, nurse practitioners, CRNAs, dentists, psychologists, mental health professionals, nurses, and other health providers in Department of Health (DOH) investigations and hearings, Drug Enforcement Administration (DEA) investigations, audits and hearings, Food and Drug Administration (FDA) investigations and hearings, FBI investigations, Medicare/Medicaid investigations, audits and hearings, and many other actions involving defense of health professionals and providers.

To contact The Health Law Firm, please call (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Minsky, David. “Fla. Man Sentenced To 15 Years In Prison Over HIV Drug Fraud.” Law360. (June 16, 2023). Web.

Becker, Zoey. “In fraud case targeting HIV meds, Florida man gets 15 years in prison.” FiercePharma. (June 21, 2023). 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 Avenue, Suite 1000, Altamonte Springs, FL 32714.  Phone:  (407) 331-6620;  Toll-Free: (888) 331-6620.

Current Open Positions with The Health Law Firm.  The Health Law Firm always seeks qualified individuals interested in health law.  Its main office is in the Orlando, Florida, area.  If you are a current member of The Florida Bar or a qualified professional who is interested, please forward a cover letter and resume to:  [email protected] or fax them to (407) 331-3030.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2023 The Health Law Firm. All rights reserved.
By |2023-06-26T11:18:27-04:00July 17, 2023|Categories: Health Facilities Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , |0 Comments

Florida Man Gets 15 Years in Prison for HIV Drug Fraud Scheme;  $230 Million Lost to Fraud

author headshot standing in dark suit with arms crossedBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On June 15, 2023, a United States District Judge sentenced a Florida man to 15 years in prison for his role in an HIV prescription drug fraud scheme that amassed more than $230 million in two years.  The defendant was initially indicted on June 17, 2022, and charged with six counts of conspiracy and money laundering.  Unlike most of the fraud convictions we report on, this one was directed against the U.S. Food and Drug Administration (FDA) and involved adulterating and misbranding drugs.  The defendant pled guilty to only two counts: conspiracy to defraud the United States and conspiracy to commit money laundering.  Click here to view the press release from the U.S. Attorney’s Office, Southern District of Florida, to learn more about the arrest


The Charges: Adulterated and Misbranded HIV Medications.

Prescription drug diversion is when prescription drugs are removed from regulated distribution channels and reintroduced into the wholesale market or otherwise illegally distributed.  These drugs can be acquired through theft, fraud, or patients who were prescribed the medication and intentionally did not consume them.
In this case, U.S. vs. Lazaro Hernandez,  the defendant would obtain prescribed drugs illegally, repackage them, falsify the documentation, and resell them to coconspirators through conspiracy wholesalers. To successfully divert the prescription medications, they got wholesale drug distributor licenses for LLC’s in Florida, New Jersey, Connecticut, and New York. These conspiracy wholesalers would purchase the diverted, adulterated, and misbranded drugs and documentation and sell them to pharmacies.
Adulteration occurs when any substance is added to or substituted, in part or in whole, or mixed with an approved drug.  Misbranding of a drug occurs when someone places a label on it that is false or misleading in any way, as defined in Title 21 U.S. Code sections 351(d) and 352 (a)(1).  In this case, the pharmacies billed health care benefit programs and dispensed adulterated and misbranded drugs to patients.  The pharmacies paid $232,800,000 for the diverted drugs between April 2019 and at least October 2021.
The six counts that the defendant was initially charged with include conspiracy to introduce adulterated and misbranded drugs and to defraud the United States, conspiracy to traffic pre-retail medical products with false documentation, conspiracy to commit money laundering, and three counts of money laundering.  The false documentation and money laundering charges were later dropped in the plea deal.

The Sentencing.

The government recommended a sentence of 188 to 235 months, which aligns with the defendant’s criminal history and total offense level (calculated in accordance with federal statutes and regulations), while the defense argued for a lesser amount of time due to the allegedly “secondary” role the defendant played in the fraud.  The judge sentenced the defendant to 180 months. Also included in the sentence was a forfeiture of all proceeds from the scam and restitution in an amount that has yet to be determined.
This lower-than-recommended prison sentence came after the defendant spoke about his gambling addiction, which allegedly led him to participate in the fraud. Also, two of his 47 character references addressed the court in person.  The judge was swayed to give him a lower sentence as a result. View the indictment in the case in full here.

Contact Health Law Attorneys Experienced with Investigations of Health Professionals and Providers.

The attorneys of The Health Law Firm provide legal representation to pharmacists, pharmacy facilities, physicians, nurse practitioners, CRNAs, dentists, psychologists, mental health professionals, nurses, and other health providers in Department of Health (DOH) investigations and hearings, Drug Enforcement Administration (DEA) investigations, audits and hearings, Food and Drug Administration (FDA) investigations and hearings, FBI investigations, Medicare/Medicaid investigations, audits and hearings, and many other actions involving defense of health professionals and providers.
To contact The Health Law Firm, please call (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Minsky, David. “Fla. Man Sentenced To 15 Years In Prison Over HIV Drug Fraud.” Law360. (June 16, 2023). Web.
Becker, Zoey. “In fraud case targeting HIV meds, Florida man gets 15 years in prison.” FiercePharma. (June 21, 2023). 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 Avenue, Suite 1000, Altamonte Springs, FL 32714.  Phone:  (407) 331-6620;  Toll-Free: (888) 331-6620.

Current Open Positions with The Health Law Firm.  The Health Law Firm always seeks qualified individuals interested in health law.  Its main office is in the Orlando, Florida, area.  If you are a current member of The Florida Bar or a qualified professional who is interested, please forward a cover letter and resume to:  [email protected] or fax them to (407) 331-3030.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2023 The Health Law Firm. All rights reserved.
By |2023-06-26T11:12:07-04:00June 26, 2023|Categories: Pharmacy Law Blog|Tags: , , , , , , , , , , , , , , , , , , , , , , , |0 Comments
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