WASHINGTON – Miami resident Aisa Perera, 42, has been sentenced to 30 months in prison for her role in an $11 million scheme to defraud the Medicare program.

Judge Federico A. Moreno of the Southern District of Florida also ordered that Perera, the former administrator of Saint Jude Rehab Center, Inc., an HIV clinic, be placed on three years of supervised release following her release from prison and pay $8,289,286 in restitution to the U.S. Department of Health and Human Services.

According to Acting Assistant Attorney General Matthew Friedrich of the Criminal Division and U.S. Attorney R. Alexander Acosta of the Southern District of Florida, Perera admitted that in June 2003, she opened Saint Jude with three others who owned and operated several HIV clinics in the Miami area. Carlos, Luis and Jose Benitez were charged separately with healthcare fraud and money laundering crimes in an indictment unsealed on June 11.

According to the separate indictment, the Benitezes are alleged to have provided the money and staff necessary to open Saint Jude, the Medicare patients that Saint Jude would bill to the Medicare program and transportation for the HIV patients who visited Saint Jude. In return, the they are alleged to have received 60 percent of all payments Saint Jude received from the Medicare program.

Officials say the Saint Jude clinic submitted approximately $11.3 million in fraudulent claims to the Medicare program for HIV infusion services that were either never provided or not medically necessary. Medicare paid more than $8.2 million of the $11.3 million in fraudulent claims. Also, patients who attended Saint Jude reportedly received approximately $100 to $150 in cash kickbacks per visit.

In a related case, on Aug. 28, 2007, medical biller Rita Campos-Ramirez pleaded guilty to one count of conspiracy to commit healthcare fraud and one count of submitting false claims to the Medicare program, charges connected to her participation in the Saint Jude fraud scheme and approximately 74 other HIV infusion fraud schemes. Campos-Ramirez admitted that over the course of three and a half years, she submitted approximately $170 million in fraudulent bills to the Medicare program.

Of the $170 million that was billed, Medicare paid approximately $105 million. Campos-Ramirez has been sentenced to 12 years in prison.

In yet another related case, on June 12, 2007, Orestes Alvarez-Jacinto pleaded guilty to one count of conspiracy to commit healthcare fraud in connection with his participation in the Saint Jude fraud scheme. He has admitted to authorizing the use of the drug WinRho for each of his patients. The drug is not necessary and could be harmful to HIV infusion patients. He also signed bills for WinRho treatments that misrepresented the amount of drugs actually administered and signed inflated bills for unnecessary procedures. Alvarez-Jacinto was sentenced on Oct. 2, 2007 to 18 months in prison.

The three cases were brought as part of the Medicare Fraud Strike Force, supervised by Deputy Chief Kirk Ogrosky of the Criminal Division's Fraud Section and U.S. Attorney Acosta of the Southern District of Florida. From investigations opened during the period of strike force operations between March and October of 2007, federal prosecutors have indicted 82 cases with 142 defendants in South Florida. Collectively, these defendants fraudulently billed the Medicare program for more than $492 million.

Have you seen Medicare Fraud in your area? Send your comments to Associate Editor Chelsey Ledue at chelsey.ledue@medtechpublishing.com.