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Miami-area clinic owner pleads guilty in $23M Medicare fraud scheme

A Miami-area resident who owned and operated an HIV infusion clinic pled guilty last week to participating in a $23 million Medicare fraud scheme, according to the Departments of Justice and Health and Human Services.

Flor Crisologo, 58, pled guilty before Magistrate Judge Barry L. Garber in U.S. District Court in Miami to one count of conspiracy to commit healthcare fraud. She had been indicted in May.

According to plea documents, Crisologo admitted to submitting approximately $23 million in false and fraudulent claims to Medicare for HIV injection and infusion services supposedly provided through J & F Community Medical Center, which she owned and operated.

According to investigators, Crisologo and a physician ordered unnecessary tests, signed false medical analyses and diagnosis forms and authorized treatments to make it appear that medical services were being provided to patients who were Medicare beneficiaries.

Crisologo admitted that she and others paid Medicare beneficiaries to claim they received services at the clinic that were either not provided or not medically necessary.

The maximum sentence for conspiracy to commit healthcare fraud is 10 years in prison. Crisologo also faces fines and forfeiture of any property or proceeds derived from her criminal activities. Sentencing is scheduled for Nov. 23.

Since inception in March 2007, Medicare Fraud Strike Force operations in seven districts have obtained indictments of more than 810 individuals who collectively have falsely billed the Medicare program for more than $1.85 billion.