Carmen Gonzalez

On December 20, 2013, Carmen Gonzalez was sentenced to 9 years in prison and ordered to pay more than $8.2 million in joint and several restitution. She was convicted at trial on charges of conspiracy to defraud the U.S., to cause the submission of false claims, and to pay health care kickbacks and conspiracy to commit health care fraud.

Gonzalez had been arrested on September 3, 2013, by FBI agents in Cape Coral, Florida, and had been indicted in 2008 on charges of conspiracy to defraud the United States, to cause the submission of false claims, and to pay health care kickbacks; conspiracy to commit health care fraud; and criminal forfeiture. In Gonzalez's health care kickback scheme, more than $11 million in false claims was submitted to Medicare.

According to the indictment, Saint Jude Rehab Center, Inc., was a purported medical clinic based in Miami, Florida. The owners of the medical clinic allegedly hired medical billers to make it appear that Saint Jude was a legitimate HIV infusion clinic providing bona fide therapy. However, they instead withdrew cash from Saint Jude's bank account in order to pay cash kickbacks to HIV patients who were Medicare beneficiaries.

Gonzalez was a nurse at Saint Jude who, along with co-conspirators, paid HIV patients who were Medicare beneficiaries between $100 and $150 in cash kickbacks to sign patient logs at Saint Jude stating that they received treatments at the clinic. Saint Jude then used the beneficiary information to order unnecessary tests, sign medical analysis and diagnosis forms, and authorize treatments to make it appear that legitimate medical services were being provided.

Saint Jude then billed Medicare for the costs of infusion, injection, and other treatments that were not medically necessary or were not provided. Medicare provided approximately $8 million in reimbursement for these false claims.

Gonzalez is a cousin of the "Benitez Brothers," who owned and directed a string of HIV infusion medical clinics in the Miami area. Carlos, Luis, and Jose Benitez received approximately $110 million from Medicare in reimbursement for medical care that was unnecessary or never provided.