Medicare: Massive fraud nets doctor 20-year sentence

She reminded de los Rios that while he is 72, he was 64 when he joined the racket headed by Metro Med's owner, Damaris Oliva, who pleaded guilty, cooperated with authorities and was sentenced to about seven years.

According to prosecutors, Oliva learned the Medicare fraud business from brothers Carlos, Luis and Jose Benitez, who owned 11 HIV clinics in Miami-Dade that billed the federal program $119 million and were paid $84 million. They fled to the Dominican Republic and then to Cuba before their indictment was unsealed in 2008. They are believed to be incarcerated in a Cuban jail on immigration violations, according to the FBI.

During the past decade, elaborate HIV schemes cost Medicare billions of dollars, according to the U.S. Department of Health and Human Services' inspector general. HIV clinics throughout South Florida — which had 8 percent of the nation's population with the virus that causes AIDS — were responsible for 72 percent of all claims for HIV infusion drugs in 2005, according to an inspector general's report.

That year, South Florida clinics — mostly concentrated in Miami-Dade — submitted $2.2 billion in HIV-drug infusion bills to Medicare for HIV drugs, according to the study. That was 22 times more than the total HIV claims submitted to Medicare by health care clinics in the rest of the country combined.

On Monday, the judge cited those statistics to dramatize her personal outrage over de los Rios' misconduct. "He signed off and participated in a fraud of huge proportions," Lenard said.

The physician's attorney, Jose Quinon, tried in vain to persuade the judge to lower the sentence to about seven years, arguing that it should be at least comparable to the prison term for Oliva. Quinon also argued that his client was ailing, with a heart condition and diabetes.

"The major issue is whether Dr. de los Rios will be able to die at home or die in some prison," Quinon told the judge. "That is what this is really about."

But Justice Department trial attorney Joseph Beemsterboer countered that the physician deserved no sympathy, arguing for 30 years in prison. He focused on the very issue that troubled the judge the most: de los Rios had been in the medical profession for decades without incident when he decided to become a criminal.

"At that point, he should have known better," Beemsterboer said, adding that authorities still have not been able to recover the $1.2 million the physician received from the clinics. "We still haven't found a dime of that money."

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