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MIAMI, FL — A Miami doctor has pleaded guilty to Medicare fraud and illegally writing prescriptions for oxycodone, hydrocodone and alprazolam. Fifty-one year-old Roberto A. Fernandez, pleaded guilty to one count of conspiracy to commit health care fraud and wire fraud. He faces a Sept. 20. sentencing date.
Appearing before U.S. District Judge Cecelia M. Altonaga on Tuesday, Fernandez admitted his role in connection with what prosecutors described as a “multi-faceted” $4.8 million health care fraud scheme.
The 51-year-old Fernandez participated in the scheme between April 2011 and February 2017.
“According to admissions made as part of his guilty plea, Fernandez referred Medicare beneficiaries to pharmacy owners in exchange for illegal health care kickbacks,” according to federal officials. “Fernandez admitted knowing that the pharmacy owners were billing and receiving reimbursements from Medicare for prescription drugs based upon the prescriptions he sold, and that his patients did not truly need many of the medications he prescribed in exchange for the kickbacks.”
For example, prosecutors said that Fernandez admitted providing prescriptions for expensive, name brand drugs, including anti-psychotics and HIV/AIDS medications that were not medically necessary.
“Fernandez also solicited referrals of Medicare beneficiaries to his own practices from his co-conspirators, he admitted, including submitting claims to Medicare under his Part B provider number for services he did not, in fact, render to Medicare beneficiaries,” officials added. “Additionally, Fernandez admitted receiving kickbacks in return for signing plans of care and prescriptions for home health services.”
Fernandez prescribed controlled substances, including opioids, to patients and patient recruiters in return for $100 to $200 cash payments for each prescription.
“Fernandez admitted that he knew these patients did not need the controlled substances he prescribed,” prosecutors explained. “Furthermore, Fernandez admitted that he wrote many of these controlled substance prescriptions for patients that he did not even examine.”
The case was investigated by the FBI, U.S. Department of Health and Human Services Office of Inspector General’s Miami Regional Office and the U.S. Secret Service’s Miami Field Office.
Assistant U.S. Attorney Lisa H. Miller of the Southern District of Florida and Fraud Section Trial Attorney Adam G. Yoffie are prosecuting the case.
Since its inception in March 2007, the Medicare Fraud Strike Force has resulted in charges against 3,000 defendants across nine states, representing more than $11 billion in charges to the federal Medicare program.