News
Apr 02 2008
Six face charges of Medicare fraud
The crime began when an employee at the Cleveland Clinic in Weston stole 1,500 Medicare patients' numbers and sold them to companies that billed the government about $8 million in bogus healthcare claims, authorities said.
The upshot: federal indictments of six Miami-Dade medical equipment suppliers on Tuesday -- following convictions of the Cleveland Clinic employee and her cousin.
The uncommon identity-theft Medicare fraud case underscores a major flaw in the nation's healthcare program for the elderly, according to prosecutors.
REPEATED USE
Medical equipment suppliers can use the stolen Medicare patients' ID numbers repeatedly to bill for such items as wheelchairs because the federal program doesn't cancel their numbers to stop the abuse after discovering it.
''While we know these numbers are being used by criminals . . . the criminals can use them again and again,'' said U.S. Attorney R. Alexander Acosta. ``That is a fundamental problem.''
The reason: the Centers for Medicare & Medicaid Services, an agency in Health & Human Services, doesn't have the authority to cancel the numbers and issue new ones.
AUTHORIZED AGENCY
Patients' Medicare ID numbers are based on their Social Security numbers. That agency is the only one with the authority to change them. Moreover, patients who believe their numbers have been stolen must initiate the request with Social Security to change them.
''The individual has to go directly to Social Security to request a new Social Security number,'' CMS spokesman Peter Ashkenaz said. ``We have no power over that.''
The arrests of the six suspects on Tuesday resulted from the FBI's initial investigation of the Cleveland Clinic employee in 2005-06.
Isis Machado, a 22-year-old front-desk coordinator at the hospital, stole the personal data of patients and sold the information to her cousin, Fernando Ferrer, 29, of Naples, for $5 to $10 for each patient. Ferrer, in turn, sold the data to phony Miami-Dade medical providers to bilk Medicare insurance companies.
Machado pleaded guilty to conspiracy, identity theft and fraud charges, then testified against Ferrer, who was convicted at trial last year.
The six Miami-Dade medical equipment suppliers are charged with submitting about $8 million in bogus Medicare bills to insurance companies for services and equipment that were never provided to the patients. In turn, the Medicare system paid them about $2.5 million, authorities said.
DEFENDANTS' NAMES
The six defendants are: Remberto Sarmiento Perez, 45, of Miami, owner of Super Medical Supply Inc. and APR Medical Equipment Inc.; Michell Gonzalez Benitez, 28, of Hialeah, owner of Premium Medical Care Inc.; Julio Perez Ramos, 33, of Miami, owner of Benefica Rehabilitation Center Inc.; Yordano Ruviera Diaz, 30, of Miami, owner of De La Torre Medical Equipment Inc.; Lazaro Hernandez Hernandez, 43, of Miami, owner of W.P. Medical Supply Inc.; and Ariel Gonzalez, 36, of Miami, owner of IMP Medical Equipment Inc.
The upshot: federal indictments of six Miami-Dade medical equipment suppliers on Tuesday -- following convictions of the Cleveland Clinic employee and her cousin.
The uncommon identity-theft Medicare fraud case underscores a major flaw in the nation's healthcare program for the elderly, according to prosecutors.
REPEATED USE
Medical equipment suppliers can use the stolen Medicare patients' ID numbers repeatedly to bill for such items as wheelchairs because the federal program doesn't cancel their numbers to stop the abuse after discovering it.
''While we know these numbers are being used by criminals . . . the criminals can use them again and again,'' said U.S. Attorney R. Alexander Acosta. ``That is a fundamental problem.''
The reason: the Centers for Medicare & Medicaid Services, an agency in Health & Human Services, doesn't have the authority to cancel the numbers and issue new ones.
AUTHORIZED AGENCY
Patients' Medicare ID numbers are based on their Social Security numbers. That agency is the only one with the authority to change them. Moreover, patients who believe their numbers have been stolen must initiate the request with Social Security to change them.
''The individual has to go directly to Social Security to request a new Social Security number,'' CMS spokesman Peter Ashkenaz said. ``We have no power over that.''
The arrests of the six suspects on Tuesday resulted from the FBI's initial investigation of the Cleveland Clinic employee in 2005-06.
Isis Machado, a 22-year-old front-desk coordinator at the hospital, stole the personal data of patients and sold the information to her cousin, Fernando Ferrer, 29, of Naples, for $5 to $10 for each patient. Ferrer, in turn, sold the data to phony Miami-Dade medical providers to bilk Medicare insurance companies.
Machado pleaded guilty to conspiracy, identity theft and fraud charges, then testified against Ferrer, who was convicted at trial last year.
The six Miami-Dade medical equipment suppliers are charged with submitting about $8 million in bogus Medicare bills to insurance companies for services and equipment that were never provided to the patients. In turn, the Medicare system paid them about $2.5 million, authorities said.
DEFENDANTS' NAMES
The six defendants are: Remberto Sarmiento Perez, 45, of Miami, owner of Super Medical Supply Inc. and APR Medical Equipment Inc.; Michell Gonzalez Benitez, 28, of Hialeah, owner of Premium Medical Care Inc.; Julio Perez Ramos, 33, of Miami, owner of Benefica Rehabilitation Center Inc.; Yordano Ruviera Diaz, 30, of Miami, owner of De La Torre Medical Equipment Inc.; Lazaro Hernandez Hernandez, 43, of Miami, owner of W.P. Medical Supply Inc.; and Ariel Gonzalez, 36, of Miami, owner of IMP Medical Equipment Inc.
