Puerto Rico Licensed Doctor Charged In Medicare Fraud Scheme

By NAN Contributor

News Americas, WASHINGTON, D.C., Fri. Mar. 24, 2017: A Puerto Rico licensed doctor, who was practicing medicine in Miami, has been charged in a 16-count indictment for his alleged participation in a multi-faceted $20 million health care fraud scheme involving the submission of false and fraudulent claims to Medicare and Medicaid.  He has also been charged with the illegal distribution of oxycodone and other controlled substances

Dr. Roberto A. Fernandez, was charged by federal authorities with one count of conspiracy to commit health care fraud and wire fraud, 11 counts of health care fraud, one count of conspiracy to defraud the United States and pay and receive health care bribes and kickbacks, one count of conspiracy to distribute controlled substances and two counts of distribution of controlled substances.

The indictment alleges that from approximately January 2011 through February 2017, Fernandez as owner and operator of the Florida-based Latin Foundation for Health Inc., referred Medicare beneficiaries and Medicaid recipients who were purportedly under his care to Calan Pharmacy & Discount Service LLC, a Medicare Part D provider, and several Miami-area home health agencies in exchange for illegal bribes and kickbacks from his co-conspirators.

It is further alleged that Fernandez submitted false and fraudulent claims through Medicare Part B for services, office visits and procedures that he never provided, such as therapeutic injections and removal of lesions from patients’ faces, and provided prescriptions for home health services and medications regardless of whether they were medically necessary.

Fernandez also allegedly illegally dispensed controlled substances, including but not limited to the Schedule II controlled substances Oxycodone and Hydrocodone and the Schedule IV controlled substance Alprazolam, to his co-conspirators.

According to the indictment, Fernandez and his co-conspirators caused Medicare to pay at least approximately $4.4 million based on false and fraudulent claims that they caused to be submitted.  The indictment also alleges that Medicare, through Part D, paid a total of approximately $20 million as a result of claims submitted listing Fernandez as the prescribing physician.

Fernandez was arrested on Wednesday, March 22, 2017, and made his initial appearanceyesterday, Thursday, Mar. 23, 2017, before U.S. Magistrate Judge Andrea M. Simonton of the Southern District of Florida.