Recently in Fraud Category

September 6, 2013

Owners of Home Health Care Companies Plead Guilty to Fraud Charges

Multiple defendants entered guilty pleas yesterday for their involvement in a $20 million Medicare fraud scheme. Roberto Marrero, Sandra Viera, and Enrique Rodriguez appeared in federal court with their respective Miami criminal defense attorneys and entered guilty pleas. The individuals that entered the pleas were either owners or operators of the home health company Trust Care Health Services, Inc. In addition to the owners and operators, a patient recruiter also entered into a guilty plea. Members of the U.S. Attorney's Office, the FBI and the U.S. Department of Health and Human Services took part in making the announcement.

Continue reading "Owners of Home Health Care Companies Plead Guilty to Fraud Charges" »

May 15, 2013

Dozens Arrested for Medicare Fraud in South Florida

Federal authorities arrested nearly 100 individuals across the country for their involvement in Medicare fraud. Twenty-five arrests were made in South Florida alone. Miami-Dade County is often considered to be the hotbed for healthcare fraud. Miami criminal lawyers have kept busy over the past few years representing clients arrested for Medicare fraud. The highest profile defendant arrested in the most recent sweep was Roberto Marrero, a Cuban born actor and businessman, who is accused of stealing millions of dollars from the federal healthcare program. Both Marrero and his wife were arrested for submitting $20 million in bills to Medicare. The bills were submitted to the program for home health care for diabetic patients. The indictment alleges that the treatments were either not necessary or never provided.

The federal investigation into Medicare fraud netted offenders from Miami to Detroit to
Los Angeles. Those arrested included doctors, nurses and clinic owners and operators. The total amount billed to Medicare by those arrested tallied approximately $223 million. Marrero allegedly began his Medicare scheme to defraud back in 2007. He is accused of using his ill-gotten gains to purchase high-end automobiles and to launch a cable TV station.

The agency responsible for the investigation and the arrests is the Medicare Fraud Strike Force. There are currently 9 regions in the United States under the watchful eye of federal investigators. Each region has its own strike force investigating cases of fraud. The president's administration has vowed to reduce the amount of healthcare fraud perpetrated in the country and claims to have improved the oversight of Medicare billing. The Medicare fraud crackdown has become a priority of the federal government as indicated by the press conference which was attended by the U.S. Attorney General and the Human Health Services Secretary.

Marrero, his wife and several other defendants made their first appearance in federal court on Tuesday. Some of the defendants were represented by privately retained attorneys. Those who cannot afford to hire private counsel will be appointed an attorney from the public defender's office or private counsel registered with the federal court to represent indigent defendants. The government is seeking pre-trial detention on the couple. Both defendants are entitled to a hearing before the magistrate presiding over the case in an effort to obtain a bond. The pre-trial detention hearing is essentially a bond hearing to determine if the defendants are eligible for a bond, an if so, the amount of the bond.

Marrero and his wife are accused owning and operating Trust Care Health Services from 2007 to 2010. The indictment accuses the couple of submitting false bills to Medicare for the treatment of approximately 700 homebound diabetic patients who could not provide insulin to themselves. The charges allege that many of the patients did not require treatment and in some cases treatment was never provided.. It is also alleged that the couple paid recruiters to find patients with Medicare cards. The federal government is trying to locate assets obtained from the illegal enterprise as part of an asset forfeiture action.

Ninety Arrested in South Florida Medicare Crackdown, Bradenton Herald.com, May 15, 2013.

December 10, 2012

Local Millionaire Arrested by Feds for Fraud

A colorful and popular socialite was arrested on Friday for fraud related charges. Claudio Osorio, along with his business partner, Craig Toll, were indicted on multiple fraud and money laundering charges. Osorio, a prominent Miami millionaire, is accused of defrauding numerous people into investing in his company Innovida. Osorio and Toll are being represented by Miami criminal attorneys. Some of Osorio's alleged victims include several current and former NBA player, such as Alonzo Mourning, Dwight Howard, Carlos Boozer and Howard Eisley. Osorio's. other victims allegedly caught up in the fraud include his neighbor, a Tanzanian businessman, and a group of investors from the United Arab Emirates (UAE). According to prosecutors, Osorio was able to lure unsuspecting investors as he and his wife threw expensive parties and gave the appearance that they were very wealthy.

In 2005, Osorio created the company Innovida which was supposed to create and market fiber-composite panels which could be interlocked to construct affordable housing and shelters for post-disaster victims, such as those from New Orleans and Haiti. He claimed that his business was forming joint ventures with Europe, Latin America, Africa and Asia. According to court documents, Osorio was able to perpetrate the fraud by assembling high-profile individuals to sit on the board of directors to legitimize his company. He was able to secure $40 million from investors, as well as, a $10 million government loan. Osorio told investors that the company had $40 million in cash with another $500 million in cash on the way from Middle Eastern investors.

Not only is Osorio and his business partner being charged criminally in federal court, but the Securities and Exchange Commission has filed civil charges for defrauding investors by overstating the financial success of the company. The complaint alleges that Osorio stole nearly half of investors' money to pay for a lavish Star Island mansion, a Colorado retreat, a Maserati and to pay country club dues. To garner support from investors, he made large charitable contributions and hosted extravagant political fundraisers. Investors became suspicious when the numbers did not add up to make a profitable company. The Swiss government also sought $200 million in repayment in loans for a previously failed business. Osorio filed for bankruptcy last year and his multi-million dollar home was sold at auction.

Osorio and Toll will likely appear at a pre-trial detention hearing in the next 24 hours. Federal prosecutors can request from the magistrate presiding over the case to hold defendants without a bond. The magistrate will decide if pre-trial detention is appropriate by determining whether the defendants are a danger to the community and whether or not they are fligh risks. In determining whether defendants are flight risks, the magistrate will consider a defendant's ties to the community. Citizenship, properties overseas and family members residing in the jurisdiction will help the magistrate make that decision. If a magistrate finds that a defendant is not a flight risk and is not a danger to the community, he will set a bond commensurate with the charged and the amount of loss suffered by the alleged victims.

High-Flying Miami Millionaire was a Fraud, Feds Say, Miami Herald.com, December 8, 2012.

June 21, 2012

Eight Arrests Made for Mortgage Fraud

Local residents were indicted and arrested for their involvement in a multi-million dollar mortgage fraud scheme that lasted almost 5 years. The focus of the investigation involved a condominium located in the Miami-Brickell area. According to the indictment, the individuals charged in federal court were part of a scheme that bilked lending institutions out of $5.7 million. The case will be prosecuted in Miami, Florida with the defendants represented by privately retained criminal attorneys or lawyers from the federal public defender's office. While mortgage fraud is difficult to perpetrate under the current banking standards, federal and state prosecutors are trying to clean up the mess that occurred at the end of the last decade.

The defendants charged in the case are facing charges of mail fraud, conspiracy to commit mail fraud and money laundering. Strawbuyers, a real estate attorney, a real estate broker and a mortgage broker were among those arrested. A title agent allegedly was also involved in the scheme and was charged separately by information. Like her co-defendants she is also charged with mail fraud, conspiracy to commit mail fraud and money laundering. Some would ask why she is charged separately by information rather than being included in the indictment with the rest of her alleged co-conspirators. Often times, cooperating witnesses will not be included in the indictment as they are expected to enter a guilty plea down the road. This is especially the case, when the cooperation began prior to the indictment being handed down by the grand jury.

Another defendant has already entered a guilty plea to charges including conspiracy to commit money laundering and wire fraud. The allegations suggest that this defendant provided false information to banks to acquire loans and received kickbacks for his involvement in the criminal enterprise. He received 46 months in prison at his sentencing hearing. Based on the loss alleged in the indictment, this sentence indicates that this defendant has agreed to cooperate with federal investigations and prosecutors with other investigations and with the offenses for which he was charged.

According to court records, the mortgage fraud scheme used straw buyers to purchase condominium units in the downtown Brickell area. Straw buyers names were used to secure loans supported by falsified financial documents. The false information was used to secure loans that exceeded the sales price of the units. Two sets of loan documents we used. The first set of documents that reflected the corrects sales price were submitted to the sellers, while a second set of inflated loan documents with the inflated price were presented to the lending institutions. The difference in the monies were taken and divided among the co-conspirators. This scheme is commonly referred to as "double hudding" and is one of the more commonplace types of mortgage fraud. While mortgage fraud is difficult to achieve under the current security standards of the banks, arrests are still being made for mortgage fraud that contributed to the housing collapse in 2008 and 2009.

Eight Miami-Dade Residents Charged in Multi-Million Dollar Mortgage Fraud Scheme, Palm Beach Post.com, June 20, 2012.

June 11, 2012

Fourteen Indicted on Identity Theft Charges

Fourteen local individuals were indicted in federal court for their involvement in a bank fraud scheme. Both men and women were indicted, but only 13 of the 14 have been arrested to date. The group is charged with being involved in an organized scheme to defraud several Bank of America customers. The defendants will appear before a magistrate with their perspective defense lawyers to determine whether each is entitled to a bond or whether the government is going to seek pre-trial detention. If the government seeks pre-trial detention, the hearing will be set within 48 hours. The government will have the burden of proving the defendant is linked to the crime and that the defendant is a danger to the community or a risk of flight. If the government can meet their burden, the magistrate can hold a defendant without a bond until the trial and/or sentencing occurs.

The alleged scheme was responsible for taking in excess of $100,000 from unsuspecting bank customers between November 2009 and June 2010. According to the United States Attorney's Office, one of the defendants was the ringleader of the operation. He is accused of stealing identities of bank customers, allowing other perpetrators to gain access to the accounts. The ringleader, Ibrahin Elias, was able to acquire the personal information of Bank of America customers, such as, names, birth-dates and social security numbers. Elias purportedly took the personal information and impersonated bank customers. Once the customers accounts were compromised, he ordered checks which were used to withdraw money out of the accounts. Once Elias had control of the accounts, he would transfer funds to accounts belonging to the other co-defendants. He is charged with several counts of bank fraud, conspiracy to commit bank fraud and aggravated identity theft.

The other defendants charged in the indictment are charged with bank fraud and conspiracy to commit bank fraud. A couple of the defendants are accused of receiving stolen funds and recruiting others to participate in the fraud. Others are simply accused of receiving stolen funds and returning the proceeds to others charged in the indictment. They received commissions for transferring the stolen money. According to court documents, each of the amounts stolen from individuals was less than $10,000 which means that were at least 10 victims involved in the crime.

Each of the defendants charged with conspiracy to commit bank fraud and bank fraud are facing up to 30 years in prison. Elias is also facing two-year minimum mandatory sentences for aggravated identity theft for each victim who had his or her identity stolen. The defendant's sentencing guidelines will determine what each individual is facing in terms of prison time. Those who cooperate with the federal investigators and prosecutors will receive the lightest sentences. Those of the defendants that choose not to cooperate with the feds will face sentences determined mostly by the amount of loss. Defendants involved in creating and managing the scheme will face more time as they will have their guidelines increased by several levels.

Arrests Made in Thefts from Online Bank Accounts, Miami Herald.com, June 10, 2012.

October 27, 2011

Five Arrests Made for Insurance Fraud

Five local residents were arrested for their involvement in a staged car accident scheme to defraud. The defendants were arrested in this county and will mostly likely be charged with insurance fraud, grand theft and staging an automobile accident. It is not known how many counts will be filed by the state attorney's office against the defendants. Anyone charged with these types of crimes should seek out experienced Miami criminal defense lawyers that have defended staged accident cases. The investigation in this case was led by the Florida Department of Financial Services Division of Insurance Fraud. This agency typically investigates insurance fraud throughout the state of Florida. The defendants purportedly contrived the fake accident and and put their plan into motion. The participants in the accident sought treatment at Doral Center Rehab and Justin Medical Services. The clinics allegedly billed $83,000 to several insurance companies for services that were not necessary or never performed.

For years, Florida has been battling insurance fraud and staged accident cases. The problem got so bad the Florida Legislature modified the laws involving staged accident cases. The Financial Services Division of Insurance Fraud is going after everyone involved in staged accident. Their main goal is to shut down clinics involved in fraud and to put the clinic owners in prison or jail. Doctors are also being prosecuted and typically required to forfeit their medical licenses in exchange for staying out of jail and rather receiving a probation plea. Prosecutors handling these cases in Miami are assigned to a specialized unit with sole purpose of prosecuting insurance fraud.
These prosecutors typically work from the bottom up pleading out the secretaries and receptionists in an effort to go after the people who reaped the most benefit from the fraud.

Insurance fraud is committed when a person presents, prepares written or oral statements in support of an insurance claim knowing that the statement contains false, incomplete or misleading information concerning any fact or thing medical to a claim. It is also unlawful for anyone to solicit others to become involved in a staged accidents with the intent and purpose of filing false motor vehicle tort claims. Anyone who plans and solicits others to participate in a staged accident with the intent to commit insurance fraud can be charged with a second degree felony and is also facing a two year minimum mandatory prison sentence. Anyone being investigated for insurance fraud for participating in staged accident schemes should speak with a qualified defense attorney as soon as possible.

There are a few things to remember when an individual is charged with insurance fraud. Obtain criminal representation as soon as possible. Never speak to criminal investigators. Under the constitution, everyone has the right to remain silent. Any statements can and will be used to prosecute someone. Never speak to your co-defendants, as they may agree to cooperate with the prosecution and those statements can be used in court as well. In general, staged accident and insurance fraud cases are created after lengthy investigation. Hundreds of documents and CD's will be provided to the defense at the beginning of the case. All of this information needs to be reviewed to determine the strength of the state's case. Only after a complete and thorough investigation of the case and the corresponding discovery can an informed opinion be made on how to defend the case.

Five PIP Fraud Arrests Made in Miami, PropertyCasualty360.com, October 26, 2011.

October 20, 2011

Feds Charge 20 South Florida Residents With Mortgage Fraud

Federal authorities charged 20 individuals with mortgage fraud with losses alleged at $20 million. Of those indicted, many are professionals in the real estate industry. According to the indictment, the alleged fraud occurred between March 2006 and June 2008 when the defendants filed false loan applications and other documents to multiple banks to obtain $40 million in bank loans and lines of credit. The banks and lending institutions lost approximately $20 million as a result of the fraud. While the problem of mortgage fraud has been largely curtailed due to stricter banking policies, Miami criminal defense lawyers are still seeing indictments coming down the pike. Mortgage fraud investigations take months if not years, as well as, the subsequent arrests. Trhis leads us to believe that more indictments will follow.

The 25 count indictment includes real estate professional such as mortgage brokers, title agents, realtors, and real estate property appraisers. The defendants are charged with federal crimes such as bank fraud, receiving gifts for procuring loans and providing gifts for procuring loans. The indictment also seeks the forfeiture of money and property derived from the transactions. The U.S. Attorney for the Southern District of Florida issued a statement saying that he had never seen an indictment involving so many real estate professionals. He claimed that his office will continue to vigorously stamp out mortgage fraud and prosecute straw buyers, sellers, corrupt mortgage brokers and bank officials. If the defendants are convicted they face up to 30 years in prison on each count and substantial monetary fines.

As in most mortgage fraud cases, some of the defendants submitted false mortgage and line of equity applications on behalf of unqualified real estate buyers and borrowers. Bank employees assisted in getting the fraudulent loans approved. To cover up the scheme, other defendants failed to record or falsely recorded mortgage deeds and documentation. To secure the loans many of the straw buyers claimed to be doctors, dentists, engineers or other high paid professionals. The investigation into this large scale mortgage fraud scheme was conducted by the Financial Fraud Enforcement Task Force. The task force was solely created to investigate and prosecute large scale organized scheme to defraud.

Mortgage fraud, although considered to be under control by the federal government, still subjects defendants charged with crime to serious terms of incarceration. The crime of bank fraud itself does not subject defendants to lengthy prison sentences, but the large amounts of losses suffered by the lending institution is what puts defendant behind bars for several years. In cases with numerous defendants, it is inevitable that some of the defendants will testify against others listed in the indictment. Cooperation with the federal government can allow for defendants facing lengthy periods of incarceration with significantly less time. The amount of the departure from the sentencing guidelines will depend on the quality and quantity of cooperation provided by the defendant turned government witness.

20 South Florida Residents Charged in $40 Million Mortgage Fraud Crime, LoanSafe.org, September 30, 2011.

September 8, 2011

Dozens Arrested in Medicare Fraud Case

Federal law enforcement authorities arrested 42 people alleged to have committed Medicare fraud throughout three counties in the South Florida area. Among those arrested were the owners of the Biscayne Milieu Health Center, a psychiatrist from Broward County, along with patient recruiters and assisted living facility landlords. Other defendants arrested in the case and accused of the fraud include home healthcare operators, HIV clinics owners and operators and medical equipment suppliers. In total, the purported criminal enterprise billed Medicare in excess of $160 million for medical services that were not necessary or in some instances never even provided to patients. Medicare paid out approximately $90 million. Broward and Miami criminal defense lawyers, either appointed by the court or privately retained will represent the defendants in the case.

According to government officials, this alleged Medicare fraud scheme was a bit different from those seen in the past. It is alleged that recruiters lured out-of-state patients to the South Florida and Miami area with the promise of giving them housing and a fresh start. Instead, the patients brought their Medicare cards with them and were placed in substandard assisted living facilities. The patients were also directed to attend mental health programs and group therapy sessions which would also be billed to Medicare. If the patients refused treatment they were kicked out of the ALF's and forced to live on the street.

The federal government continues to vigorously investigate and prosecute Medicare fraud cases in cities such as Miami, Brooklyn, Detroit and Los Angeles. Forty million people a year claim benefits, but the program has suffered billions of dollars in losses as a result of fraud, waste and abuse. With politicians and the federal government under the gun for losses incurred in the federal healthcare system, a new computer software program was initiated with the hope that the losses could be curtailed. The new program is said to be a proactive approach to defeating fraud, however, investigators claim the program is inadequate and that the federal government will continue to combat fraud after it has been committed.

Anyone being investigated for or having been arrested on these types of fraud charges must seek out legal counsel as soon as possible. Defendants charged in healthcare schemes to defraud are facing significant terms of incarceration because of the amount of losses suffered by Medicare. While fraud is a relatively low offense under the federal sentencing guidelines, the offense becomes much more severe when the losses accrue in excess of a million dollars. Owners and operators of clinics involved in illegal billing are also subject to multi-level increases if it determined that they were the leaders of organizers of the fraud. In any event, the feds continue to investigate and hunt down all those alleged to be involved in these types of criminal enterprises.

Medicare Fraud Case Nets Dozens of Arrest, Miami Herald.com, September 7, 2011.

July 27, 2011

Former Trafficker Charged with Medicare Fraud

A South Florida man previously convicted of cocaine trafficking and money laundering has been charged with committing Medicare fraud. The indictment alleges that Luis Alejandro Sanz, who had previously served a five year prison sentence, opened a healthcare clinic to purportedly treat diabetes patients. Court documents allege that he billed the federal healthcare provider $11 million of which he actually received $7 million. Because of his past criminal record, Sanz enrolled his wife as the sole proprietor of the clinic to avoid detection. Both defendants are scheduled to appear in court with their Miami criminal attorneys this week for their arraignment.

Earlier in the week Sanz and his wife were indicted on charges of healthcare fraud, money laundering and for paying kickbacks. The clinic operated from 2006 to 2009 obtaining clients through the use of patient recruiters. This is not the first instance where previously convicted felons have turned to healthcare fraud. Despite the law that precludes individuals with prior felony convictions from being Medicare providers, several have slipped through the cracks. While it is almost impossible for the federal healthcare agency to detect who put the money up to start and run the clinic, the Medicare program has dumped millions of dollars into its security system in an effort to prevent millions of dollars of fraud from occurring.

Congress awarded Medicare $350 million in the Affordable Care Act to develop software which allows for stricter screening of Medicare claims. Previously, Medicare used the "pay and chase" method for combating fraud. While many prosecutions and convictions resulted from this approach, the federal government could not recoup the money after the scams had already been completed. The new software being used by the healthcare program along with stricter screening for healthcare providers is intended to prevent the fraud and save the taxpayers millions of dollars. Time will tell if the new initiative will be more effective in combating fraud than its predecessor.
The upgrades in fraud prevention come as a result of millions of dollars in losses to the federal government. It is well documented that the majority of fraud is an was committed in Miami and throughout the South Florida area. Along with the fraud detection upgrades, the Medicare fraud task forces across the country are working in concert and sharing information.

While Medicare fraud itself is not a serious offense as far as punishment is concerned under the federal sentencing guidelines, the risk lies in the multi-level increases that are directly correlated to the amount of the loss suffered by Medicare. In South Florida, Defendants charged with Medicare fraud are facing 24 to 48 months if they enter guilty pleas and cooperate with government prosecutors and investigators. Defendant who go to trial and are convicted by a jury are looking anywhere form 10 to 20 years depending on their involvement in the fraud. At the present time, individuals charged with Medicare fraud are in the cross hairs of the United States Attorneys Office. Any charged with or being investigated for healthcare fraud, should retain a criminal lawyer with experience in defending these types of cases in federal court.

Former Miami Drug Trafficker Now an Accused Medicare Scammer, Miami Herald.com, July 27, 2011.

July 11, 2011

Feds Launch Medicare Anti-Fraud System

Federal officials finally launched the long awaited computer system to combat Medicare fraud. South Florida has been declared "ground zero" for Medicare fraud. A federal task force operating out of Miramar, Florida was the first to use the new program. For the last couple of years, the federal government has spent large sums of money and man hours to combat the crime. Numerous defendants have been sentenced to multi-year prison terms despite the efforts of the Miami criminal defense lawyers representing them. While in the past, the system used to detect and prosecute Medicare fraud has been mainly reactive, the new computer system definitely reflects a more pro-active approach to fighting the offense. While the use of the program began in South Florida, the system is being used nationwide to prevent the theft of millions of dollars from the federal healthcare program.

The new federal system is called "predictive modeling" and is designed to examine millions of Medicare claims filed on a daily basis. The program looks for suspicious claims to prevent fraudsters from using recruited patients or in the alternative using stolen Medicare identification numbers. According to Peter Budetti, the man leading the initiative, the new system will help identify similar scams occurring across the country. The new anti-fraud system is being used by all Medicare fraud task forces, some of which are set up in Miami, Detroit, Houston and Los Angeles. With all that being said, the federal government will continue to apply pressure to all those involved in healthcare schemes to defraud.

Federal investigators, last month, charged 21 defendants accused of stealing $21 million from the federal government. Six of the defendants are from the Miami area while the remainder were operating out of Michigan. Over the past year, South Florida prosecutors have charged in excess of 102 defendants with billing the federal government $441 million in fraudulent claims. Since 2007, the Medicare strike forces have been involved in the arrest in excess of 1,000 individuals responsible for filing $2.3 billion in fraudulent claims. South Florida led the way with $1.85 billion in fake claims. While it is not clear how much has been lost to fraud, estimates have reached as high as $60 billion. The new system of detection is designed to prevent the fraud from occurring while the old system was used to detect it after the fraud had already been committed.

Being investigated for or charged with Medicare fraud is a serious matter. The federal sentencing guidelines take into consideration the amount of loss in determining a potential sentence. The offense of fraud itself is only a level 6 offense. The problems lie with the multi-level increases that occur when substantial losses to federal healthcare system occurred. The cases prosecuted by the federal government are complex and indictments usually contain dozens of defendants. The defense of these types of cases should not be taken lightly and only qualified defense attorneys with experience in the arena should be retained to represent clients charged with this offense.

Medicare Anti-Fraud System Launched, Orlando Sentinal.com, July 11, 2011.


June 28, 2011

Local Doctor Sentenced to 20 Years for Medicare Fraud

A federal judge sentenced a doctor to 20 years in prison for his involvement in a Medicare fraud scheme that cost the federal healthcare system millions of dollars. The defendant appeared with his Miami criminal attorney and attempted to avert a lengthy prison term by arguing that his client should not die in prison and that he suffers from a heart condition and diabetes. The federal court judge presiding over the sentencing hearing felt little sympathy for the defendant. On the record, the judge chastised him for violating his medical oath, billing the Medicare system and disgracing himself, his family and the community. The defendant was found guilty of charges involving his receipt in excess of a million dollars for writing fake prescriptions with the intent to defraud Medicare. The jury found that the doctor was involved in billing Medicare for HIV treatments that were unnecessary or never provided to patients.

The sentence handed down was the second harshest ever involving a medical doctor convicted of being involved in healthcare fraud. A Miami-Dade physician was charged with a similar Medicare fraud in 2008 and was sentenced to 30 years in prison. That sentence was upheld last year in appellate court with a former United States Supreme Court Justice sitting as a guest judge. She declared, "a doctor should be treated more severely than other participants because the doctor is breaching a position of trust and an ethical obligation to put the patient's interests first." The judge hearing the case yesterday repeated ths same sentiments. The defendant helped operate the scheme using two clinics to bill Medicare. The owner of one of the clinics suffered a far less fate as she cooperated with the government to prosecute other perpetrators.

In federal court, defendants that cooperate with government receive significantly reduced prison sentences than those who go to trial and are convicted by a jury. While cooperating with the government against people you know and used to work with is definitely a difficult situation, it is far better than receiving a double digit prison sentence. Every defendant in federal court should seek qualified representation before deciding to accept or reject a plea. While this decision is always difficult, the case and the evidence supporting it must be critically analyzed to support this decision. The benefit of accepting a plea results in significant level reductions under the sentencing guidelines and of course the benefit of a large sentence reduction that comes with a 5K supported by federal prosecutors.

Federal prosecutors continue to focus on Medicare fraud cases involving HIV treatments, as clinics, mostly in the Miami-Dade area, have billed in excess of $2.2 billion worth of infusion bills. Clinics in the South Florida are have billed for 72% of all HIV Medicare claims despite the fact that only 8% of the population with HIV reside in the same area. While the defense lawyer representing the doctor attempted to appeal to the softer side of the judge, government prosecutors convinced her that the defendant deserved no sympathy and should be sentenced to 30 years in prison. Both the government and the judge focused on the fact that the defendant was a doctor and should be sentenced accordingly for this breach of trust.

Medicare Fraud Nets 20-Year Prison Sentence for Miami Physician, Miami Herald.com, June 27, 2011.

April 11, 2011

Defendant Enters Guilty Plea in Federal Medicare Fraud Case

A South Florida woman entered a guilty plea in the Southern District of Florida for her involvement in the largest Medicare fraud case in the nations's history. Margarita Acevedo appeared with her Miami criminal defense attorney in federal court. She is facing between 12 and 15 years in prison for her role in the $200 million healthcare fraud. The indictment alleges that Ascevedo recruited senior citizens with mental health issues residing at assisted living facilities (ALF's) and halfway houses. The proprietors of these establishments would send hundreds if not thousands of patients to seven mental healthcare facilities operating under the name of American Therapeutic.

Acevedo was one of 24 individuals indicted for their involvement in the multi-million Medicare fraud scheme. She and the other defendants are facing long prison sentences. The lengthy prison sentences are not attributable to the crime itself, but the federal sentencing guidelines take into account the amount of loss to the victim when calculating a sentence. Medicare fraud along with other offenses such as larceny, forgery or theft start at a base level offense at 7. Levels will be added depending on the amount of the loss to the government, financial institution, or individual. Other level increases exist depending on the actions of the defendant and the type of victim involved in the case. Anyone interested in looking at the guidelines for these types of offense should check section 2B1.1 in the sentencing guidelines.

Despite the lengthy sentence Acevedo is facing on paper under the federal sentencing guidelines, she will likely on serve a third or even a half of the time she was facing as a result of her cooperation with federal prosecutors and law enforcement investigators. The government will expect many things from her in order for her to receive a significant sentence reduction. First, she will be required to speak with law enforcement and describe in detail the inner workings of the operation. She will also be required to point the finger at the owners and operators of the clinics who provided the fraudulent treatment. She will be required to lay out for the government which individuals at the ALF's and halfway houses were referring over patients and receiving kickbacks. Finally, she may be required to testify against any and all of these individuals at trial.

Acevedo and other individuals at American Therapeutic recruited the living facilities to send patients in exchange for kickbacks. Personnel at the facility would receive $30 for every patient referred over to the clinics. As usual, Medicare did not discover the fraud despite the unusually high number of claims being filed by American Therapeutic. The fraud was only discovered after clinic employees complained that the patients being sent over were beyond help. The owners of the clinics have also been charged and relayed their intent to plead guilty once the amount of loss has been fairly calculated. As stated earlier, the amount of loss is critical in determining the amount of time someone is facing for fraud related charges in federal court.

First Miami Defendant in Nation's Biggest Health Fraud Case Pleads Guilty, Miami Herald.com, April 8, 2011.


February 15, 2011

Federal Authorities Make Numerous Medicare Fraud Arrests

The feds are at it again and made 16 arrests for individuals allegedly involved in Medicare fraud. The arrests come as part of what has been dubbed by the government as the largest fraud in Medicare's history, to the tune of about $200 million. Residents of Miami-Dade and Broward Counties were the subjects of the arrests. The case will be prosecuted locally which means that the majority of the defendants will be represented by Broward and Miami criminal defense lawyers. The defendants include doctors, health care administrators and other employees that worked for a company called American Therapeutic.

The defendants are going to appear today in federal court for there first appearance. Several things occur at the first appearance. The defendants have the right to have a private criminal attorney appear on their behalf or request a short continuance in order to retain counsel. If a defendant is comfortable with his or her counsel, the lawyer can file an appearance and address the matter of the bond. The judge or magistrate presiding over the case will determine the amount of the bond based on two simple factors which are the safety of the general public and a defendant's ties to the community which will assure the magistrate that the defendant will appear for all court hearings. In considering the safety of the general public, the magistrate will consider the type of crime for which a defendant was arrested and the defendant's prior criminal history.

In determining whether the defendant's ties to the community merit a particular bond, the magistrate will consider the citizenship of a defendant, property ownership, and the locale where his family, in particular where his or her spouse and children reside. As part of the bond, the defendant or his family may be required to sign as personal guarantors for the bond or be required to put up real estate as collateral for the bond. Typically, a defendant will be required to surrender his or her passport as a condition of the release. At the bond hearing or first appearance, counsel may seek a bond reduction on behalf of his or her client. Once the first appearance portion of the case is completed, the case will be set for an arraignment. At the arraignment, a defense attorney will file a permanent notice of appearance on behalf of the client and will also become aware of the charges the client is facing. At the arraignment, a trial date will be set for the case.

In federal court, trial dates are set quickly and judges do not like to grant continuances. Continuances are generally granted based on the complexity of the charges and the number of defendants listed in the indictment. Because the current Medicare fraud case referred to earlier involves such a substantial loss and thousands of documents will be used as evidence to prove the case, along with 16 co-defendants, the case may stay open for about a year. During that time, defendants will most likely enter pleas to reduce their exposure. Some of the defendants will even enter into agreements with federal prosecutors to testify against other co-defendants. The potential sentences in this case will be extremely high, mostly because the federal sentencing guidelines factor in the amount of loss to the victim which in this case is the federal government and the Medicare program. The only real way to escape the guidelines to cooperate with the government or obtain an acquittal at trial.

Feds Make More Arrests in Major Medicare Fraud Case, Miami Herald.com, February 15, 2011.

January 20, 2011

South Florida Resident Charged with Credit Card Fraud in Tampa Area

A local man was arrested and charged with dozens of counts of credit card fraud and identity theft. He is being accused of being involved with a ring that engages in credit card theft throughout the State of Florida. According to police reports, at the time of the arrest, the defendant had in his possession 109 fraudulent credit cards. Juan Echemendia's bail has been set at $1.825 million. While the defendant is facing a large of number of charges and serious prison time, a good defense team may prevail in his case. Recently, two Miami criminal attorneys appeared in Hillsborough County and won a motion to suppress of behalf of three clients. The court granted the motion and dismissed the information containing in excess of 50 counts.

The defendant is being investigated in other counties by various law enforcement agencies which may lead to additional arrests for identity theft, credit card and possession of fraudulent credit cards. The allegations may be so wide spread that the Florida Department of Law Enforcement may be involved in the cases. Four other suspects have also allegedly been caught on camera with the defendant committing identical crimes. It is not clear if law enforcement will attempt to use the defendant to catch the other suspects, but his assistance could certainly help him secure his release.

Many of the credit card fraud cases are defensible as long as the suspect does not admit to the crimes. The first step is to attempt to get the bail requirement reduced at a bond hearing to secure one's release. Credit card fraud and identity theft cases are fairly complex with voluminous discovery. If a defendant can not make bail, he or she will sit in custody while the defense in the case is prepared. The next step is to evaluate the evidence in the case. If the fraudulent credit cards were used in a retail store, surveillance video of the transaction may exist and can be used by the prosecution at trial. Dozens of police reports are generated in large investigation and must be evaluated to determine where the credit cards were found, what names appeared on the credit cards and by what method the police seized the credit cards.

How the police seized the credit cards is extremely important. The recently won case in Tampa by way of a motion to suppress occurred as a result of an illegal stop ordered by the lead detective. The detective received information from another detective that a person residing in Tampa was involved in marijuana trafficking. The detective set up surveillance on the residence and observed an individual carry a black to garbage bag to the rear of the vehicle. The detective could not see or smell the marijuana. The detective ordered the vehicle stopped and its occupants searched. Two of the passengers possessed fraudulent credit cards. A search of the residence revealed a marijuana grow house and more stolen credit cards. Because the detective did not have reasonable suspicion to stop the vehicle, the judge suppressed the evidence and dismissed all of the charges. This is an example of how and experienced criminal lawyer can win a case even when there appears to be insurmountable evidence against a defendant.

Suspect in Statewide Credit Card Fraud Ring Arrested in Herando, The St. Petersurg Times.com, January 20, 2011.

January 17, 2011

Local Law Enforcement Still Making Insurance Fraud Arrests

The Chief Financial Officer for the State of Florida announced six recent arrests involving staged accidents and insurance fraud. Other than mortgage fraud and Medicare fraud, staged accident insurance fraud remains problematic for both politicians and law enforcement. Although Miami criminal attorneys have seen a decrease in the number of staged accident cases hitting the court dockets, arrests are still being made. According to reports, Florida led the nation in false insurance claims related to staged accidents, with New York and New Jersey close behind. The problem became so serious in South Florida, that the Miami-Dade County State Attorney's Office assigned the prosecution of these fraud crimes to a specialized unit. However, Florida tallied approximately 30 arrests last year which was down from previous years.

Insurance fraud is covered under Florida Statute 817.234. Insurance fraud is defined as anyone who presents or causes to present a claim for payment to an insurance company knowing that the information provided was false, incomplete or misleading. Insurance fraud is a third felony punishable up to five years in prison. First-time offenders will often be offered a pre-trial intervention program as long as the person has no prior criminal history. However, the legislature changed the law in staged accident cases because of the large number of fraudulent activity reported.

The current state of the law specifically target individuals who organize, plan or knowingly participate in staged accidents. If individuals fall into these categories and motor vehicle insurance claims were made on behalf of the participants involved in the fraud, the offense is increased to a second degree felony, but more importantly the offense carries a two year minimum prison sentence. Even first-time offenders with no prior criminal record to speak of, still face a prison sentence. While the offense is serious, there are ways to defend these types of cases.

Criminal defense attorneys know that the strength of the prosecutor's cases generally lies with witnesses who have agreed to cooperate with the state in an effort to avoid a jail sentence. In many cases, the state only has testimony of charged and uncharged witnesses trying avoid being prosecuted. Knowing this, it is important to remember never to provide a statement to law enforcement or detectives. Any inculpatory statement will corroborate the testimony of the state witnesses and cause serious problems in defending the case. Anyone contacted by law enforcement regarding a staged accident should seek out and obtain advice from a criminal defense law firm with experience in defending insurance fraud cases.

Six Arrested in Miami for Allegedly Staging Accidents, Sun-Sentinal.com, January 17, 2010.