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DOJ files lawsuit against 25 Miami-area defendants for alleged Medicare fraud

By Mark Iandolo | Apr 30, 2016

MIAMI (Legal Newsline) – The Department of Justice filed lawsuits against 25 Miami-area defendants in three separate cases for alleged schemes to defraud Medicare of roughly $26 million in false claims through the Medicare Part D program.

“These cases build on our recent efforts to focus on Medicare prescription drug benefit fraud, targeting those who take advantage of the fastest-growing component of the Medicare program,” Assistant Attorney General Leslie R. Caldwell said. “Working with our partners in the Medicare Fraud Strike Force, the Criminal Division uses cutting-edge data analysis techniques to identify emerging fraud schemes and to stay ahead of the criminal curve.”

In United States v. Kenia Gonzalez et al., the defendants allegedly conspired to defraud the United States and pay and receive kickbacks. In United States v. Ronald Diaz et al., the defendants purportedly committed health care fraud and money laundering. In United States v. Antonio Hevia et al., the defendants allegedly ran a scheme to defraud the Medicare Part D program through false claims from eight pharmacies in the Miami-Dade County area.

“A dangerous trend is fraudulent pharmacy billing for drugs,” Special Agent in Charge Shimon R. Richmond said. “But exploitation of the Medicare prescription drug benefit will not be tolerated and suspects will face aggressive investigation and prosecution.”

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U.S. Department of Justice