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Medicare Fraud Strike Force Cases Result in Long Prison Terms

by Barbara Kram, Editor | December 18, 2007
DOJ cracks down
on Medicare fraud
WASHINGTON - The owners of five separate Miami-based health care corporations have been sentenced to prison terms, Assistant Attorney General Alice S. Fisher of the Criminal Division and U.S. Attorney R. Alexander Acosta of the Southern District of Florida announced. Collectively, the five defendants filed fraudulent claims with Medicare for over $28.6 million worth of unnecessary durable medical equipment (DME) and infusion therapy.

The five defendants who were sentenced in Miami are: Rodolfo Aenlle, 47, who was sentenced to 84 months in prison; Simon Seruya, 74, who was sentenced to 50 months; Alberto Gourie, 35, who was sentenced to 51 months in prison; William Garcia, 31, who was sentenced to 41 months; and Marina Ruiz, 48, who was sentenced to 24 months in prison. In total, these individuals were ordered to repay more than $13 million in restitution.

Aenlle, the owner of Direct Nursing Assistance, was sentenced by U.S. District Judge Donald M. Middlebrooks. On Oct. 4, 2007, Aenlle was convicted by a jury following a four-day trial. Evidence presented at trial established that Aenlle's corporation was a fraudulent DME company that had nothing to do with providing health care or nursing services. Yet, during 2001 and 2003, Direct Nursing submitted claims to Medicare of $2 million and co-conspirator pharmacies billed more than $205,000. Aenlle and his business partners paid patients cash kickbacks and did not use any of the equipment or medicines that were paid for by Medicare. In total, the co-conspirator pharmacies associated with Aenlle were paid over $14 million between 2000 and 2003 based on the submission of claims for medically unnecessary "compounded" aerosol medication. Compounding is the process whereby pharmacies make medication in quantities or concentrations that are not available in FDA approved forms. Aenlle entered into an arrangement with several corrupt Miami pharmacies to "compound" medicine based on prescriptions for non-commercially available medications.
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Seruya was sentenced by U.S. District Judge Marcia G. Cooke for his involvement in two separate Medicare fraud schemes. Seruya owned and operated Bedat Management, Inc., a fraudulent HIV infusion clinic, and Medical Respiratory Equipment, Inc., a fraudulent DME company. Between 2001 and 2004, Seruya used these two companies to submit over $15.5 million in fraudulent Medicare claims. Seruya pleaded guilty on Sept. 26, 2007. Seruya operated Bedat as an infusion clinic and paid HIV positive Medicare patients cash kickbacks to allegedly administer unnecessary medications such as Intravenous Immune Globulin and Intravenous Rho D Immune Globulin.