Medicare Compliance & Reimbursement

INDUSTRY NEWS:

Medicare Fraud Funds Extravagant South Florida Lifestyle

Marquez bought $55M worth cars, horses, and diamonds.

On Jan 5, 2010, Ihosvany Marquez, of Miami-Dade County, was indicted on charges of conspiring to commit Medicare fraud on a scale rarely seen before. Another defendant in the same case -- Michel De Jesus Huarte -- who had already been indicted in a closely-related Medicare fraud scheme in September 2009, pled guilty in November 2009 according to a press release from the United States Attorney, Jeffrey H. Sloman's office.

"This is an absolutely massive Medicare fraud scheme, even by Miami standards," Assistant U.S. Attorney Ryan Stumphauzer said about the case when pushing for a no bond.

To this Marquez's lawyer, Michael Walsh replied, "You don't think he's going to use one of these horses to flee?" according to the release.

Marquez -- along with Huarte and several other unnamed conspirators -- were siphoning off money from the public exchequer as far back as 2007. The modus operandi was simple. Marquez and his associates operated seven medical clinics in Orange and Miami-Dade counties which were used as fronts for fraudulent activity, the release indicated. By the time the feds caught up with them, they had submitted at least $55 million in false claims (based on which Medicare paid them approximately $21.6 million) to Medicare for infusion therapy, injection therapy, and other expensive medical treatments designed to treat Medicare beneficiaries with cancer, HIV, AIDS, chronic pain, and varicose veins, the release further said.

According to the charges framed by feds, Marquez and his conspirators recruited nominees -- or "straw" owners -- for each company, who were paid large sums of money to sign corporate records, bank records, and other business documents before fleeing the country. But not everybody could. One such individual, Madelin Machado, 36, of Zigma Medical was caught up with and indicted in the Southern District of Florida in January 2008, but is a fugitive today and is believed to be in Cuba, according to the FBI. Machado is charged with fraudulently billing Medicare for more than $9M and collecting $4.5M.

Investigations have also shown that Marquez certainly did not stash his loot. $2.7M of the money went toward the purchase of numerous luxury and exotic cars; he further spent more than $500,000 on jewelry, and more than $1million on horses, the release indicates.

(Editor's note: For the United States DOJ's press release on this case, visit: www.justice.gov/usao/fls/PressReleases/100104-01.html.)

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