Doctors Face Jail for
HIV Medicare Fraud

Four medical workers were convicted of fraud after filing $5.3 million in false HIV-therapy claims to Medicare.

Physicians David Rothman and Keith Russell and medical assistants Eda Marietta Milanes and Jorge Luis Pacheco were found guilty on Tuesday, according to the U.S. Department of Justice.

Medicare paid two Miami-Dade clinics, Medcore Group LLC and M&P Group of South Florida Inc., $2.5 million for bogus HIV treatments. To make the claims, the physicians manipulated blood samples, prescribed obsolete drugs to patients, and falsified medical records.

Tony Marrero, an owner of both clinics, testified that the clinics were set up mainly to fraudulently garnish Medicare dollars. He also said that he met with pharmaceutical wholesaler Lifecare Medical to buy invoices showing the purchase of large amounts of medication, when only small amounts were actually bought.

The scheme involved 20 patients who were paid up to $200 for each visit to the clinic. Four patients said they took the cash but never received medication from the clinics. One patient said he didn't even have the virus, despite records showing he was being infused with HIV medication.

Medcore medical assistant Luz Borrego testified that she falsified several patients' blood samples so that lab results would support the clinic's Medicare claims. However, Borrego said she did not give patients the medications because she knew it would harm them.

It was also shown that Rothman and Russell were involved in other HIV clinics across Miami-Dade County, and had written prescriptions totaling at least $60 million in fake treatments between 2004 and 2005.

All pleading guilty prior to the trial were Borrego, Marrero, his wife, Belkis Marrero, his brother-in-law, Orlando Pascual, Lifecare Medical owner Harold Sio, and clinic employee Alberto R. Gonzalez.

Pacheco also reportedly attempted to escape the country during trial proceedings. According to the DOJ, he was caught on March 14 with $12,600 in cash, a fake driver's license, and a contact sheet listing several people in the Dominican Republic. He also cut off his ankle monitor, violating the terms of his pretrial release. Pacheco told authorities that he was "going fishing."

"The Medicare program relies on physicians to be the first line of defense against fraud," Bernardo Rodriguez of the Department of Health and Human Services said in a press release. "As in this case, when doctors shirk that responsibility and steal from Medicare, we have to prosecute them to the fullest extent of the law."

Rothman faces up to 50 years in prison, while the other three may serve up to 30 years behind bars. Sentencing is scheduled for June 26.