November 2012 Archives

November 20, 2012

Federal Judge Sentences Patient Recruiters

A federal judge in the Southern District of Florida sentenced two defendants for their involvement in a medicare fraud case. Both defendants were patient recruiters that worked for mental health clinic called Biscayne Milieu Heath Care Inc. According to prosecutors, the defendants were involved in a healthcare scheme to defraud which billed Medicare in excess of $50 million. Both defendants appeared with their Miami criminal attorneys at the sentencing hearing. Anthony Roberts was sentenced by the federal judge to 87 months in prison and ordered to pay approximately $900,000 in restitution. Derek Alexander received a 42 month prison sentence and was ordered to pay a little over $300,000 in restitution. Both defendants took their cases to trial and were convicted by a jury for conspiracy to commit a healthcare fraud and for receiving kickbacks.

These two defendants were only small fraction of individuals prosecuted for their involvement in Medicare fraud committed at Biscayne Milieu. Owners, managers, doctors, therapists, patient brokers and other employees were among those charged in federal court for the white collar crime of Medicare fraud. The majority of the defendants were charged with healthcare fraud, money laundering and paying and receiving "kickbacks". All of the defendants were prosecuted in one of two indictments which were unsealed in September 2011 and June 2012. To date, 25 members of the scheme to defraud have either entered guilty pleas or have gone to trial. The majority owners and operators of the clinic, as well as a doctor went to trial and were convicted on a multitude of charges. They are scheduled to be sentenced in federal court on December 20, 2012.

To prove the crime of heathcare fraud, Prosecutors involved in the case submitted evidence at trial that the aforementioned perpetrators submitted false claims and bills to Medicare. Biscayne Milieu submitted in excess of $50 million dollars in claims to Medicare. The company operated fictitiously as a partial hospitalization program (PHP) treating individuals with severe mental health illnesses. The owners/operators of the clinic hired recruiters to bring ineligible Medicare beneficiaries for treatment that was never provided. The majority of the people recruited were ineligible for multiple reasons. Some of the recruits were drug users, while other suffered from severe cases of Alzheimers of dimentia. Patients with these issues could not benefit from the treatment they were purportedly receiving at the clinic.

The Medicare Fraud Strike Force continues to investigate and prosecute cases involving healthcare fraud. The strike force is now fully functional in nine cities in the United States. Since the strike force's inception, 1,480 defendants have been charged and prosecuted in federal court. Fraud is not a particularly high offense level under the federal sentencing guidelines. However, it is the amount of loss to the healthcare program that is causing defendants to serve multi-year prison sentences. Of course the sentences are higher if a defendants loses at trial rather than accepting a guilty plea in their case.

Two Patients Recruiters Sentenced in Miami for Roles in $50 Million Medicare Fraud Scheme, FBI.gov, November 16, 2012.

November 15, 2012

Husband Suspected of Murder, Questioned and Released

Detectives questioned a local man regarding the murders of his wife and two young daughters. The estranged husband was questioned in the Kendall district station by homicide detectives. After several hours of questioning, Alberto Sierra was released from the police station, but remains a person of interest for the murder of Gladys Machado and her daughters. Police investigators have vowed to continue the investigation until the guilty party is apprehended. While Sierra voluntarily spoke to the police about the pending investigation, experienced Miami criminal attorneys will always dissuade their clients from giving statements to law enforcement. Any statements provided to the police, while seemingly harmless in the event the suspect denies the allegations, can be used to implicate an unknowing suspect. For example, although a suspect denies committing the actual crime, his statement might place him at the scene the at the time the offense was committed. Bottom line, never provide statements to the police as a suspect may be inadvertently building a case against himself.

Besides speaking with suspects, investigators are anxiously awaiting the results of forensic testing conducted on physical evidence impounded at the murder scene. It sometimes takes several weeks for the forensic lab testing to be completed at the Miami-Dade Police Department crime lab. The crimes lab performs a variety of forensic testing including, DNA, ballistics, fingerprinting and gun shot residue (GSR). The medical examiner's office will also perform autopsies on the victims to ultimately determine the cause of death. Both the crime lab results and the medical examiner's findings will eventually be used to prosecute the person formally charged with the offenses.

Machado and her daughters were last seen alive leaving her grandmother's house located in Homestead, Florida. The bodies were later found in North Miami at a home where Macahdo used to live with Sierra. The home was vacant at the time and investigators have no idea how the bodies arrived at that location. The location of the bodies and Sierra's significant criminal history most likely lead him to be a person of interest. Sierra has a history of gun and drug charges, as well as, a history of domestic violence. While living with Machado at the house where the bodies were discovered, Sierra pled guilty to the offense of possession of a firearm by a convicted felon and was sentenced to 364 days in the Miami-Dade County jail.

Prior to her marriage with Sierra, Machado had been previously married to Michael Padrino and resided in Miami Beach. After the marriage ended, she moved to Homestead to live with her grandmother who helped care for the children. Soon after the divorce, Machado married Sierra despite warnings from friends and family. Sierra was released certainly because the homicide investigators did not have probable cause to make an arrest. However, once the forensic experts and medical examiner complete their investigations, an arrest may be made if the results either link Sierra to the murder scene or the murder weapon.

Miami-Dade Police Question, Release Estranged Husband of Woman Slain with Daughters, Miami Herald.com, November 15, 2012.

November 8, 2012

Leon County First to Issue Civil Citations in Lieu of Criminal Arrests

The State of Florida's criminal justice system has become so overburdened that alternatives are being sought to relieve the pressure. The criminal justice system has seen success using alternatives to arresting juvenile offenders. The use of civil citations in juvenile cases has been successful in Miami, as well as in Leon County. Criminal lawyers in Miami, Florida have long been proponents of a change in the system that will allow for issuing citations instead of making arrests in minor criminal cases. Leon County was chosen to run the pilot program because it has great success over the past 17 years using a similar program for juvenile offenders. Miami has also had great success with the program for juveniles. Statistics show that of the 7,000 juvenile offenders receiving citations, only 7% re-offended.

If the program is successful in Leon County, it could be implemented statewide. Alternatives to incarceration could save tax payers millions of dollars and decrease the pressure on the department of corrections. The program would only apply to non-violent offenders. The program will allow police officers to use their discretion to determine whether an adult offender should be arrested or receive a civil citation. The program will only be offered for offenders with no prior criminal record. These first time offenders would be saved the embarrassment of an arrest. Additionally, first-time offenders will not have to come up with the necessary funds to post a bond.

The new program will mostly apply to adults arrested for minor misdemeanor offenses such as petit theft or possession of marijuana. Currently, Miami police officers will arrest offenders accused of those offenses, however, the officers usually issue these individuals a "promise to appear" rather than carting them off to jail. A "promise to appear" is technically an arrest with the only difference being that the violators are not taken to jail or required to post a bond. Issuing a promises to appear is left to the discretion of police officers. Cooperative defendants are usually issued this courtesy, while non-compliant or combative defendants are taken to jail.

The plan being implemented in Leon County will required offenders to take part in an assessment with 72 hours of the issuance of the citation, perform 25 hours of community service, undergo treatment for drugs or gambling that led to the commission of the offense, and be required to bear the costs of both the evaluation and treatment. Most are in favor of the plan as it will reduce the population in the county jail, along with a significant cost reduction by limiting mandatory medical screening for defendant booked into the jail. Those involved with the program are looking forward to a statewide implementation. However, there are certain areas of the state that are not as receptive as Leon County. If Leon County can show the cost savings at their county jail, other jurisdictions may follow suit.

Tallahassee Plans Citations as Arrest Alternative, NBC-2.com, October 31, 2012.