With federal agents leading Medicare fraud busts nationwide and in the nation’s Medicare fraud capital of Miami last week, a drug-dealing Miami doctor pleaded guilty to conspiracy to commit healthcare fraud.
The case of Miami’s Roberto Fernandez, similar to Miramar doctor Joaquin Mendez’s Friday guilty plea to the same charges in a different case, demonstrates if greed fuels these schemes, doctors can be the engine. Fernandez admitted in court documents that just his role in the schemes cost Medicare $4.8 million. His guilty plea could cost him a maximum of 10 years in prison.
Working from 2011 to earlier this year with pharmacy owners Niurka Fernandez (doing 10 years on fraud charges) and Arturo Oms (eight years), Fernandez wrote prescriptions and made referrals of Medicare beneficiaries for Medicare kickbacks.
All three billed Medicare for drugs that weren’t necessary and sometimes not given to the patients in whose names they were billed to Medicare. And he used name brand drugs for the unnecessary prescriptions, allowing for more fraudulent billing from Fernandez and Oms. Like Mendez, he contributed his signature to care and prescription plans that allowed for fraud in home health care.
Fernandez admitted to billing Medicare for services not rendered. But, perhaps most damagingly, Fernandez admitted to being part of the state's opioid crisis by prescribing controlled substances oxycodone, hydrocodone and alprazolam to patients and patient recruiters for $100 to $200 per prescription.
“Too many trusted medical professionals like doctors, nurses, and pharmacists have chosen to violate their oaths and put greed ahead of their patients,” Attorney General Jeff Sessions said in a statement after Thursday’s monsoon of healthcare fraud arrests. “Amazingly, some have made their practices into multimillion dollar criminal enterprises. They seem oblivious to the disastrous consequences of their greed. Their actions not only enrich themselves often at the expense of taxpayers but also feed addictions and cause addictions to start. The consequences are real: emergency rooms, jail cells, futures lost, and graveyards.”
In announcing the 412 arrests Thursday, the Department of Justice said, “The charges also involve the individuals contributing to the opioid epidemic, with a particular focus on medical professionals involved in the unlawful distribution of opioids and other prescription narcotics.”