A medical doctor and one of the owners of several infusion clinics pleaded guilty to conspiracy to commit healthcare fraud in violation of 18 U.S.C. Section 1349, and were sentenced on June 26, 2017, by the United States District Court for the Middle District of Florida. The doctor, Miguel Burgos, was sentenced to 64 months in prison, two years of supervised release, and agreed to restitution of $9.8 million. Yosbel Marimon, one of the owners of the infusion clinics involved, was sentenced to 90 months in prison, two years supervised release, agreed to the $9.8 million in restitution, and consented to the forfeiture of real property valued at $1.7 million.
The case, brought by the Fraud Section of the Criminal Division of the U.S. Department of Justice, and the United States Attorney’s Office for the Middle District of Florida, concerned several infusion clinics in Orlando, Florida. Dr. Burgos acted as a medical director of the clinics, and also served as an officer, director and registered agent for three of the clinics. The healthcare services at issue were infusion therapy medications which included anticancer chemotherapeutic drugs, as well as physical therapy. Dr. Burgos and Mr. Marimon admitted to submitting false healthcare claims for reimbursement to Medicare and private insurance companies from about July 2008 through September 2011 in the approximate amount of $13.7 million, of which $9.8 million was paid.
Dr. Burgos primary role in the conspiracy included allowing the clinics to utilize his provider number to submit fraudulent healthcare claims. He also signed medical records, and allowed others to sign his name to medical records, which authorized infusion therapy drugs to be administered when in fact they were found to be medically unnecessary, never provided to the patient, and never even purchased by the clinics. He also signed medical records, and allowed others to sign his name to medical records, which authorized physical therapy treatment even though the clinics did not have a licensed physical therapist on staff.