|Charges||Health care fraud, forfeiture|
Rafael Rodriguez Gonzalez was arrested in April 2012 at Miami International Airport, after arriving from Cuba.
On September 15, 2012, Gonzalez was sentenced to 2 years and 3 months of incarceration and ordered to pay $247,707 in restitution.
In April 2011, Gonzalez was indicted on charges of health care fraud and forfeiture. Investigators believe that Gonzalez, through his durable medical equipment (DME) company, submitted more than $1.7 million in Medicare claims for medical supplies that were either not provided to Medicare beneficiaries or not medically necessary.
According to the indictment, Gonzalez operated Venus Medical Supply, Inc., a DME company based in Hialeah, Florida. From approximately November 2008 until March 2009, Gonzalez allegedly caused Venus Medical to submit more than $1.7 million in Medicare claims for wound care supplies, urinary catheter supplies, and other DME purportedly provided to Medicare beneficiaries, to which Medicare provided $247,844 in payments.
However, investigators interviewed the top two referring physicians whose names were on the claims submitted by Venus Medical and learned that the physicians did not prescribe any of the services in question nor were they familiar with any of the beneficiaries listed on the claims. In addition, investigators determined that more than 20 beneficiaries filed complaints with Medicare alleging that they did not receive services that were billed by Venus Medical.
- Health Care Fraud