The charges are part of the largest ever healthcare fraud enforcement action by the Medicare Fraud Strike Force, involving 601 charged defendants across 58 federal districts, including 165 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving more than $2 billion in false billings.

TAMPA – Thirteen in Tampa have been charged as part of a national healthcare fraud takedown, according to the Office of the U.S. Attorney for the Middle District of Florida.

They were charged in connection with their their alleged participation in various fraud schemes involving, among other things, healthcare fraud, distributing and dispensing controlled substances not for a legitimate medical purpose and outside the usual course of professional practice, conspiracy to solicit and receive health care kickbacks, and theft of government funds.

The charges are part of the largest ever healthcare fraud enforcement action by the Medicare Fraud Strike Force, involving 601 charged defendants across 58 federal districts, including 165 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving more than $2 billion in false billings. Of those charged, 162 defendants, including 76 doctors, were charged for their roles in prescribing and distributing opioids and other dangerous narcotics. Thirty state Medicaid Fraud Control Units also participated in Thursday’s (June 28) arrests.

“The FBI Tampa Division is committed to working collaboratively with our federal, state and local partners to address the opioid crisis and health care fraud in our communities. The tireless efforts put forth by the investigators and attorneys in this investigation will have a significant impact and we will continue to work with a sense of urgency to identify others involved in similar schemes,” said Eric W. Sporre, special agent in charge of the FBI Tampa Division.

The accused and the charges, according to the U.S. attorney:

Dr. Charles Gerardi has been charged with conspiracy, health care fraud, and obstruction of a federal audit. Gerardi is a licensed psychologist who was formerly associated with a group practice known as Geriatric Psychological Specialists.  According to court documents, GPS contracted with nursing homes and other long-term care facilities to provide psychological services to residents. For years, Gerardi impermissibly billed Medicare for providing medically unnecessary psychotherapy to Medicare beneficiaries who suffered from severe dementia and, at times, he billed for psychotherapy when he was actually performing medication management, a non-covered service when performed by a psychologist. First Coast initiated an audit of Gerardi’s practices in 2012. Gerardi is accused of trying to obstruct the audit by creating phony patient records and providing those records to the auditor. Finally, when First Coast placed Gerardi on prepayment review for the 20-minute billing code he had used for years, Gerardi is alleged to have changed his submitted billing code to reflect 45-minute sessions while he continued to provide patients only 20-minute sessions.

Dr. Zachary Bird was charged in a six-count indictment with distributing and dispensing controlled substances not for a legitimate medical purpose and outside the usual course of professional practice. Bird is an anesthesiologist who operated a pain management clinic called Physicians Wellness and Pain Specialists in Tampa. According to court documents, this clinic functioned as a “pill mill” where Bird prescribed large quantities of opiates to his patients. Specifically, from January 2015 to the end of May 2018, Bird prescribed approximately 5.2 million tablets of hydrocodone, methadone, morphine, and oxycodone at PWPS. Bird was arrested Monday (June 25).

Dr. Jeffrey Abraham has pleaded guilty to a one-count information charging him with distribution of controlled substances not specified by his DEA registration. Abraham was previously employed at two local Veterans Affairs hospitals in the Tampa area. As a VA physician, he was authorized by the DEA to write prescriptions for controlled substances only as part of official federal duties. According to the plea agreement, Abraham resigned from the VA to work at a pain management clinic in Tampa. His official federal duty registration was not transferable, and Abraham did not obtain a new DEA registration to write controlled substance prescriptions to the patients he saw while employed at the clinic. From August 2017 to March, while at the clinic, Abraham wrote more than 2,000 prescriptions for controlled substances, including more than 600 prescriptions for hydromorphone and more than 1,000 prescriptions for oxycodone. On March 8, Abraham admitted to federal agents that he knew his official federal duty DEA registration number could not be used at the clinic, and agreed to surrender his DEA registration.

Alcira Mercedes Wells and her former husband, Edward Leonard Wells, Jr., have been charged with conspiracy, healthcare fraud, and aggravated identity theft.  According to the indictment, between May 2014 and February 2015, Centurion Compounding, a marketing firm that was located in Florida, employed representatives to market compounded medications for conditions like pain and scars to beneficiaries of healthcare benefit programs, especially TRICARE. Lifecare and Oldsmar Pharmacies billed the beneficiaries’ health care benefit plans for these creams, which ranged in price from approximately $900 to $21,000 for a one-month supply. Lifecare and Oldsmar, at various times, paid Centurion a portion, about 50 percent, of each claim paid by the healthcare benefit programs, minus expenses, for each prescription. Centurion, in turn, paid its marketing representatives a percentage of each paid claim, which ranged from 15 percent to 30 percent of the total claim amount after expenses.

Dion Gregory Fisher and Samuel Blaine Huffman have been charged with conspiracy to possess with the intent to manufacture and distribute, and possession with the intent to distribute, counterfeit oxycodone pills made with fentanyl and a fentanyl analogue. Fisher is also charged with multiple counts of distributing the counterfeit oxycodone pills and engaging in money laundering-illegal monetary transactions using proceeds of the drug crimes.

Phillip Morose has been charged with conspiracy to possess with the intent to distribute and to distribute counterfeit oxycodone pills made with fentanyl and a fentanyl analogue, the U.S. attorney said.

Christopher McKinney has agreed to plead guilty to conspiring with Fisher, Morose and others to manufacture and distribute counterfeit oxycodone pills made with fentanyl and a fentanyl analogue. According to the plea agreement, Fisher and McKinney manufactured and sold counterfeit oxycodone pills. Fisher supplied the fentanyl and pill processing materials, and pressed the powder fentanyl into counterfeit oxycodone pills with the help of Huffman.  McKinney sold the pills to Morose, using the U.S. Mail to exchange packages of pills and currency. His change of plea hearing is set for Monday (July 2).

Konrad Guzewicz has entered pleas of guilty to four counts of money laundering. According to the plea agreement, Guzewicz engaged in illegal monetary transactions involving proceeds of the drug crimes with which Fisher has been charged. Guzewicz admitted that Fisher recruited him to launder large sums of cash generated by the distribution of counterfeit oxycodone pills made with fentanyl and other controlled substances or analogues, and he personally participated in the laundering of at least $120,000 in drug proceeds for Fisher.

Caridad Limberg-Gonzalez and Dr. Thomas Carpenter have been charged with one count of conspiracy to commit health care fraud and wire fraud, four counts of health care fraud and three counts of making false statements in connection with heath care matters. According to the indictment, Limberg-Gonzalez owned Foundational Health, a Tampa-area clinic, and Carpenter was the medical director there. Between May 2011 and October 2016, Limberg-Gonzalez caused Foundational Health to submit $1.8 million in claims to Part B of the Medicare program listing Carpenter as the rendering physician. In truth, the services were provided by nurse practitioners, physician’s assistants, and medical doctors who were not enrolled in the Medicare program, all without any supervision by Carpenter. In addition, Limberg-Gonzalez is accused of giving Carpenter plans of care and face-to-face encounter forms authorizing home health services to sign. Carpenter allegedly signed the documents, even though he never saw or cared for the patients identified in those documents.  According to the indictment, Accurate Home Health, a Tampa-area home health agency, relied on the documents that Carpenter signed to submit approximately $762,000 in claims to Part A of the Medicare program.

Roselle Fitzgerald has been charged with one count of theft of government funds, two counts of false statement to a federal agency, seven counts of counterfeit or forged securities, and three counts of fraudulent use of a means of identification. According to the indictment, Fitzgerald worked as a title closer at various law firms while simultaneously obtaining Social Security Disability Insurance and Medicare benefits to which she was not entitled. She also made material false statements to employees of the Social Security Administration regarding her work activity. In addition, Fitzgerald possessed counterfeit or forged checks from the law firms at which she was employed and used the means of identification of others in connection with the counterfeit or forged checks. The indictment also notifies Fitzgerald that the U.S. is seeking a money judgement in the amount of $192,091.20, the proceeds of theft of government funds and the counterfeit or forged securities.

The Medicare Fraud Strike Force operations are part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. The Medicare Fraud Strike Force operates in 10 locations nationwide. Since its inception in March 2007, the Medicare Fraud Strike Force has charged more than 3,700 defendants who collectively have falsely billed the Medicare program more than $14 billion.

This operation also highlights the great work being done by the Department of Justice’s Civil Division. In the past fiscal year, the Department of Justice, including the Civil Division, has collectively won or negotiated over $2 billion in judgements and settlements related to matters alleging health care fraud.

U.S. Attorney | Crime | Healthcare Fraud | Medicare | Tampabay News

#USAttorney #Crime #HealthcareFraud #Medicare #TampabayNews