Medical Equipment Suppliers Going to Prison for Medicare Fraud
Four Family Members to Serve Nearly Five Years and Pay $1.4 Million
The family members owned three medical equipment supply companies in Miami, Florida. Carlos Berenguer, 61, and Aristides Berenguer, 64, owned Select Medical Equipment Incorporated. Brother Robert Berenguer, 58, owned and operated a similar business, Professional Medical Equipment, Inc, and Carlos' stepson, Ivan Aguera, 34, owned Palm Medical Equipment. The Berenguers and Aguera "recruited and paid cash" to Medicare patients to submit false claims to Medicare, according to the DOJ press release.
The scheme consisted of Medicare patients turning in claims for oxygen concentrators and "compounded" aerosol medications, which are medications that are created by a pharmacist, rather than being pre-assembled by the pharmaceutical company that sells the drug. As medical equipment suppliers cannot bill Medicare directly, the Berenguers and Aguera worked with owners of Miami pharmacies to bill Medicare through patients. The pharmacy owners and the Berenguers and Aguera then split the money that Medicare paid the pharmacies.
Patients received cash payments for the use of their Medicare cards and information. The patients, who were clients of the three durable medical equipment (DME) suppliers owned by the Berenguers and Aguera, were referred to three Miami pharmacies, Lily's Pharmacy, Unimed Pharmacy, and Prestige Pharmacy, which "compounded" the aerosol medications illegally, and then billed Medicare for the unnecessary medications. The Berenguers and Aguera also worked with some doctors to write fraudulent prescriptions for the medications.
Another member of the family, Ricardo Aguera, was sentenced to 121 months in prison back in March for his part in the scheme. It was during Ricardo Aguera's trial that the Berenguers and Ivan Aguera entered their guilty pleas in this case. The pharmacy owners involved in this case are Henry Gonzalez and Alfonso Rodriguez. All in all, nearly $20 million was paid out to the pharmacies, with $1.4 million in claims being directly attributed to Carlos, Aristides, and Robert Berenguer and Ivan Aguera from 2001 to 2003. The four men will pay that amount in restitution for their part in the fraud scheme.
This particular type of "compounding" scheme is the most common healthcare-related fraud in Southern Florida. The DOJ has been cracking down on Medicare fraud as part of an initiative launched in December 2005 between several federal agencies to address the growing number of healthcare-related fraud schemes, especially those that occur in Florida. The Miami-Dade area alone has more claims filed for DME-related costs than most states.
Sources: US Department of Justice, Federal Bureau of Investigation
Published by alex cruden
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