Florida Couple Accused of Medicaid Fraud For False Mammograms

Friday, March 18, 2016
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law


On March 9, 2016, authorities in Florida arrested a Kissimmee couple accused of Medicaid fraud. Oscar Alzate and Alba Garcia, owners of Digital Radiology Center, Inc. and Medisound, Inc., are accused of fraudulently billing Medicaid for more than $180,000 worth of mammography services never rendered. The couple, neither who are physicians, allegedly operated a clinic without the appropriate Agency for Health Care Administration (AHCA) licensure or proper oversight by a physician as required by Florida law.


False and Defective Mammography Services.


According to authorities, the clinics allegedly provided defective mammography services and forged doctor’s signatures on medical reports. They also allegedly billed Medicaid for patients who told investigators that they had never been to, or undergone any treatment at either clinic, according to a press release issued by Florida Attorney General Pam Bondi’s office. Read the press release in full here.


The FDA Issued Safety Warnings Against the Clinics in the Past.

The U.S. Food and Drug Administration (FDA) issued a safety warning against the clinics in 2010 after they were made aware of problems with the quality of services performed, such as mammograms. Patients who received such services from the clinics were told to have their mammograms reevaluated and possibly repeated, as the facilities did not meet certain high quality standards.

The FDA also released another safety warning two years later in 2012, after learning the clinics had problems with their accreditation. After inspections, investigators found that they “had performed mammography services while their facilities were uncertified and failed to perform required testing on its equipment,” according to the safety report.


The Repercussions.


The Florida couple both face one count of Medicaid fraud, a first-degree felony, one count of scheme to defraud, a first-degree felony, and one count of violation of the Health Care Clinic Act for operating an unlicensed health care clinic, a third-degree felony. If convicted, each defendant faces up to 75 years in prison, and more than $180,000 in fines and restitution.

In 2014, The Health Law Firm succeeded in getting a medical doctor employed by the Kissimmee couple dismissed from a multi-million dollar civil monetary penalties case. The couple, who were the actual owners of the radiology facility, had fraudulently listed him as the owner to avoid licensing requirements. After a period of intense litigation representing the physician against the FDA, the client was completely dismissed from the case. Click here to read our press release from the prior case.


Contact Health Law Attorneys Experienced in Handling Medicaid Audits, Investigations and other Legal Proceedings.

Medicaid fraud is a serious crime and is vigorously investigated by the state MFCU, the Agency for Health Care Administration (AHCA), the Zone Program Integrity Contractors (ZPICs), the FBI, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (DHHS). Often other state and federal agencies, including the U.S. Postal Service (USPS), and other law enforcement agencies participate. Don’t wait until it’s too late. If you are concerned of any possible violations and would like a confidential consultation, contact a qualified health attorney familiar with medical billing and audits today. Often Medicaid fraud criminal charges arise out of routine Medicaid audits, probe audits, or patient complaints.

The Health Law Firm’s attorneys routinely represent physicians, dentists, orthodontists, medical groups, clinics, pharmacies, assisted living facilities (ALFs), home health care agencies, nursing homes, group homes and other healthcare providers in Medicaid and Medicare investigations, audits and recovery actions.

To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.


Sources:

Allen, Stephanie. “Bondi: Scammers got $180k for ficticious mammograms.” Orlando Sentinel. (March 9, 2016). Web.

“Florida Couple Arrested for Medicaid Fraud Related to Mammograms.” My Florida Legal. (March 9, 2015). Web.


About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida area.  www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.        


KeyWords: Medicaid fraud, fraudulent billing, false mammography services, defective mammography services, Florida Attorney General Pam Bondi, Florida Department of Health (DOH), U.S. Food and Drug Administration (FDA), safety warning, scheme to defraud Medicaid, the Health Care Clinic Act, Agency for Health Care Administration (AHCA), licensure issues, Medicaid fraud defense attorney, Florida licensure defense lawyer, health law attorney, health care law, The Health Law Firm

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
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3/18/2016

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