|Charges||Conspiracy and Health care fraud|
On November 18, 2014, Miguel Angel Hernandez and Maria Del Pilar Moreira were indicted on charges of conspiracy and health care fraud. Investigators believe that the married couple caused the submission of nearly $7 million in false claims to Medicare.
Hernandez and Moreira owned and operated East Point Medical Center and Family First Medical Center in Georgia, which purportedly provided physical therapy, occupational therapy, massage therapy, and pain management through trigger point injections. According to the indictment, Hernandez and Moreira caused the submission of false claims to Medicare and Medicaid for medical services that were either medically unnecessary or were not provided. They also billed for expensive trigger point injections (for which Medicare pays between $58 and $60) when, in fact, they actually provided vitamin B-12 shots (for which Medicare pays around $0.66). In addition, the couple billed for medical services on days when they actually drove patients to restaurants for parties.
Hernandez and Moreira directed clinic employees to transport patients by van to the clinics. Beneficiaries were offered massages, cash, gift cards, food, dollar prizes, and raffles for televisions to induce them to visit the clinic on a regular basis. Instead of receiving medical treatment, the patients often participated in group exercises, such as riding a stationary bike, holding a bar and kicking to the left and right, and waving their arms. To further the fraud, the couple hired a medical doctor so they could falsely bill services under his provider name and number. They then caused the submission of false claims for services not rendered by the provider or for services on days when the provider was not at the clinic.
- Health Care Fraud