Couple accused of leading Medicare fraud | Miami Herald

Editor's note: Story originally published May 26, 2007

In what was described as one of the biggest healthcare fraud cases ever in South Florida, federal prosecutors on Friday accused a couple of leading a billing company that bilked Medicare out of $56 million over a six-year stretch.

Mabel and Abner Diaz were accused of operating All-Med Billing Corp. of Miami Lakes in a scheme that used 29 durable medical equipment firms to submit false claims to Medicare.

"This is one of the most important cases ever filed by our office, " U.S. Attorney R. Alexander Acosta said. "This is our money which could have been used to treat patients rather than line the pockets of the accused."

Prosecutors have been building their case since 2004, when they went into court to get a civil restraining order to stop the Diazes' company from continuing to bill Medicare because they had engaged in a "massive, aggressive, avaricious Medicare fraud scheme, " according to an agent's affidavit.

Starting in 1998, the indictment alleges, All-Med Billing Corp. used a series of durable medical equipment suppliers, many of which were open for only a few months, getting generally $1 million or $2 million each from Medicare and then folding before investigators charged the owners.

The firms allegedly billed -- but never provided -- equipment such as power wheelchairs, artificial limbs, oxygen concentrators and powered air mattresses.

All-Med Billing Corp.'s activities went on for much longer than most fraud-based healthcare enterprises, said prosecutor David Frank, because the billing activities added "an extra layer" to the investigation, beyond the DME company's claims.

OTHERS CHARGED

Charged along with the Diazes were Suleidy Cano, Amry "Pablo" Garcia, Davel "Manny" Hernandez, Rene Raimundo Hernandez, Jose Luis Palma Jr. and Luis Enrique Gonzalez.

Altogether, the eight persons were charged with 46 counts, mostly on fraud charges. Each charge carries a maximum penality of 10 years' imprisonment.

Much of the $56 million is alleged to have vanished, according to the indictment, through money laundering. The Diazes face an extra 20 years in prison on those charges, the U.S. Attorney's Office said.

Prosecutors are also requesting the criminal forfeiture of $32,292 in cash found in their home, funds in various bank accounts, their Miami Lakes home (valued at $307,000 according to county property records) and properties in Little Havana, Hialeah and Lehigh Acres.

MASSIVE COSTS

At a press conference to announce the arrests, Timothy J. Delaney of the Miami office of the Federal Bureau of Investigation said healthcare fraud is estimated to run into the "hundreds of millions of dollars" each year in South Florida alone.

Acosta said his office prosecuted 68 healthcare fraud cases in 2006 -- a 30 percent increase over the year before. South Florida accounted for about one-fifth of all federal healthcare fraud cases in the country in 2006.

All-Med Billing Corp. was dissolved in September, according to the indictment. Its last address listed in state corporate records was 15165 NW 77th Ave., Suite 2010, Miami Lakes. The Diaz-owned company is not related to other companies with similar names.