Four Indicted in Puerto Rico on Medicare Fraud Charges

Reprinted from Caribbean Net News
caribbeannetnews.com
Federal grand jury in Puerto Rico hands down indictments in Medicaid fraud
Published on Thursday, March 5, 2009
By María Miranda Sierra
Caribbean Net News Puerto Rico Correspondent
Email: miranda@caribbeannetnews.com
SAN JUAN, Puerto Rico: A federal grand jury in Puerto Rico has returned a 30-count indictment, charging four individuals with conspiracy to commit health care fraud, soliciting and receiving kickbacks in relation to the Medicare Program and making false statements.
The indictment also contains forfeiture allegations for $513,108.35, including two real estate properties, US Attorney for the District of Puerto Rico Rosa Emilia Rodríguez-Vélez, said in a news conference.
Defendant Dr Carlos Pentzke-Chamorro was the owner and director of Eastern Cardio Diagnostic Inc. (ECD), located in Bayamón. ECD was a diagnostic radiology group practice that provided diagnostic testing and interpretations of x-rays, bone density, ultrasound and other tests. ECD purported to perform nerve conduction studies (“NCS”), including the physician interpretation of those NCS tests.
The second and third defendants, Ligia Lemus De Pentzke (Dr Pentzke’s wife) and Myriam Rodríguez-Santiago were employees at ECD and co-conspirators. The fourth defendant, Dr Oscar Arroyo-Nieves, was paid kickbacks, at least 23 times according to the indictment, by co-defendants Pentzke and his wife, in exchange for signing previously completed false nerve studies for the corporation.
They are accused of unlawfully enriching themselves by falsely and fraudulently representing that Nerve Conduction Studies had been purportedly rendered, when in truth and in fact they knew no such tests/studies had been performed correctly and the interpretation component was not done as required by the Medicare regulations.
As a result of the false and fraudulent claims, there was approximately one million four hundred twenty thousand nine hundred twenty dollars ($1,420,920.00) billed to Medicare and that resulted in five hundred thirteen thousand one hundred eight dollars and thirty-five cents ($513,108.35) in Medicare reimbursements to be paid to the ECD.
“This scheme of paying kickbacks to doctors to sign for work not performed and fraudulently filing claims with Medicare, as I have said in the past, it ultimately affects all of us,” said FBI Special Agent in Charge Luis Fraticelli. “This health care fraud only promulgates higher health insurance costs, and therefore an increase in medical costs to the general population. This fraud may also jeopardize the Medicare fund for future generations.”
The maximum penalties for these crimes are 10 years imprisonment, 3 years of supervised release and $250,000 dollar fine.