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Former NYC HIV/AIDS clinic owner sentenced to five years in prison for $12 million fraud

Authorities say Jorge Juvier and co-conspirators paid patient kickbacks, coached them to lie, billed Medicare for drugs never administered.

Beth Jones Sanborn, Managing Editor

Jorge Juvier, 58, of Queens, New York, a former owner and operator of multiple HIV/AIDS clinics in New York City, was sentenced Tuesday to a little more than five years in prison and ordered to pay more than $12 million in restitution for his role in a scheme to bilk Medicare out of more than $12 million through the use of fraudulent HIV/AIDS clinics, the U.S. Attorney's office announced.

As part of the Medicare fraud scheme, authorities said Juvier and his co-conspirators paid patients cash kickbacks for coming to the clinics. He also coached patients to lie to clinic doctors to facilitate fraudulent billing, and billed Medicare for medications that were either never administered, were administered at incorrect dosages, or that were not medically necessary. 

Juvier and his co-conspirators set up and operated multiple health care clinics in New York City that claimed to offer injection and infusion treatments to HIV/AIDS patients who were eligible for Medicare. Authorities called them health care fraud mills and said they regularly billed Medicare for drugs that either were never provided, were given in highly diluted doses, or were often medically unnecessary.

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According to the U.S. Attorney's office, who cited court documents, statements and other records, Juvier and his co-conspirators recruited HIV/AIDS patients who were eligible for Medicare to visit his clinics multiple times each week for months on end to receive expensive treatments that were in fact not needed, including drugs costing hundreds of dollars per dose that were typically reserved for cancer and anemia patients.  Juvier and his co-conspirators paid the patients cash kickbacks of up to $300 per week.  Patients were also offered roughly $50 for each additional client they referred to his clinics. 

[Also: Running list of notable 2016 healthcare frauds]

Juvier also told patients to lie to clinic doctors and tell them they had medical conditions they did not actually suffer from, subsequently submitting fraudulent bills to Medicare for reimbursement for the treatments patients claimed to have received. These claims often resulted in tens of thousands of dollars in reimbursements per patient, the U.S. Attorney's Office said.

From 2009 through 2013, Juvier and his co-conspirators robbed the Medicare system of at least $12 million, authorities said.

Juvier was ordered to pay $12,233,292.23 in forfeiture and $12,233,292.23 in restitution. The Department of Health and Human Services-Office of the Inspector General, IRS-Criminal Investigation Division, and the Federal Bureau of Investigation worked on the investigation. 

Twitter: @BethJSanborn