In Miami’s very deep sea of Medicare fraud, Carmen Gonzalez was a minnow.
So when federal agents recently nabbed her after five years on the lam, it didn’t exactly make a splash. But her arrest was the latest in an under-the-radar round-up of fugitive scammers who have branded Miami with the dubious title of the nation’s capital of healthcare corruption.
Gonzalez had played a supporting role in one of the region’s biggest, baddest Medicare rip-offs. She first worked as a cleaning lady, and then as a nurse who paid kickbacks to patients, for the notorious Benitez brothers — three sharks who ran 11 Miami-Dade clinics that swindled a staggering $84 million from the taxpayer-funded program, authorities say.
In the spring of 2008, Gonzalez and her father, Enrique, who also worked for the Benitez brothers, fled Miami after they were separately charged. The brothers — Carlos, Luis and Jose — also left Miami soon after they were indicted that May.
Where did they all go? Cuba — No. 1 among Latin American destinations of choice for South Florida’s Medicare fraud fugitives. Together, they stole hundreds of millions of dollars by filing billions in false claims for everything from medical equipment to HIV-therapy infusion drugs.
Gonzalez and some 30 other defendants have been captured over the last half-dozen years, with the pace of arrests beginning to pick up this year. There are still another 150 fugitives from outstanding Medicare fraud cases in South Florida, most of them Cuban-born immigrants who fled to Cuba, Mexico, the Dominican Republic and other Spanish-speaking countries to evade federal trials. View more of the fugitives in our database.
With the exception of Cuba, several foreign countries with U.S. extradition treaties have assisted federal authorities with making arrests and returning fugitives to the United States.
Though progress has been plodding, agents have collared 10 fugitives this year alone, compared to a previous pace of one every couple of months, said Randall Culp, the FBI special agent who supervises healthcare fraud investigations in South Florida.
“We’ve been whittling down the number on a case-by-case basis,” Culp said. “Agents are persistent in trying to locate the fugitives and eventually law enforcement catches up with them.”
“Sometimes we just get lucky.”
In September, for example, FBI agents caught up with Gonzalez, a cousin of the Benitez brothers, after she had sneaked back into this country through the Mexican border. She made the mistake of reapplying for a Florida driver’s license while living in the Fort Myers area with relatives.
In mid-October, she found herself dressed in an orange inmate jumpsuit, standing in the courtroom of U.S. District Judge Federico Moreno — the very judge she had blindsided five years earlier when she jumped bail, fleeing the country after the judge had granted her a $50,000 bail when she asked to visit Disney World for her son’s birthday. The Orlando trip turned out to be a ruse.
“Where did you go? Why didn’t you show up in court?” Moreno asked Gonzalez, before she pleaded guilty to a bond-jumping charge last month. “I went to Cuba,” answered Gonzalez, who now goes on trial for Medicare fraud in December.
Gonzalez’s defense attorney, Joel DeFabio, said she “panicked” in May 2008 when she fled with her son and husband.
“She found that life in Cuba was hard, especially for her son,” said DeFabio. “She saw no future in Cuba and wanted to give her son a better life, so she returned to the United States.”
At the time of her initial arrest, Justice Department prosecutors had warned that Gonzalez — charged in an $11 million Medicare fraud scheme at one of the Benitez brothers’ clinics, St. Jude Rehab Center, and suspected of assisting eight of their other HIV-therapy clinics in the Miami area —was a flight risk. They also noted that her father, also charged as a bookkeeper and patient recruiter at two Benitez brothers’ clinics, had just fled the country.
Moreno, the court’s chief judge, had himself just issued a memo in 2008 warning his colleagues not to set low bonds for Medicare fraud defendants, citing a rising increase in fugitives.
So the judge was not amused when Gonzalez forfeited a $7,500 bond down payment, and didn’t show up for her next hearing that June. The judge lamented that Cuban immigrants were coming to the United States, gaining lawful residency and stealing from the Medicare system — and then returning to their native country with ill-gotten gains.
“It seems to me that our thinking has to change — that someone from Cuba can flee back to Cuba just like someone from Mexico,” Moreno told Gonzalez’s attorney, DeFabio, at the time. “I don’t know what your client’s situation is, but money goes a lot farther in Cuba.”
Despite those cautionary words, the pattern of South Florida’s Medicare offenders fleeing to Cuba, Mexico and other Latin American countries continued to climb until judges in the last few years began rejecting bond requests before trial.
The FBI has maintained a list of at least 90 South Florida Medicare fraud fugitives identified by name, compiled by Special Agent Bryan Piper. The bureau, assisted by Health and Human Services-Office of Inspector General, also has a list of an additional 90 defendants who have been charged by sealed indictment, but also are suspected of having fled the region. As a result, they are unaware they are wanted in Miami, and agents don’t want to tip them off.
So far, about 30 fugitives have been busted. Culp said that most South Florida fugitives typically get caught while they are on the lam in foreign nations, or when they return to this country through Miami International Airport.
An example: In 2009, Alcides Garcia, wanted for his role in a $10.7 million medical equipment ring, went to a shipping company in the Canary Islands to have his personal belongings sent from Miami to the Spanish island off the northwestern coast of Africa.
Garcia kept saying he was Mexican, but his heavy Cuban accent was a dead giveaway.
So, the shipping company owner Googled Garcia’s name and up popped a Miami Herald/El Nuevo story published in January 2009 that described Garcia as a Cuban-born fugitive wanted on Medicare fraud charges in South Florida. The story, which carried a mug shot of Garcia, confirmed his identity.
The owner called the FBI in Miami with an anonymous tip, and the Spanish National Police did a background check and arrested him on a provisional federal warrant at a hotel in Madrid. Garcia, 49, who had used his real name but a false Mexican passport, was eventually sentenced to eight years in prison.
The bureau also has had success dealing with other foreign countries.
Last February, for example, Colombian authorities extradited a woman who had walked out of her 2006 healthcare fraud trial in Miami just before the jury convicted her of operating a $5 million HIV-therapy racket.
In 2012, the FBI caught up with Magda Luz Lavin after Colombian authorities received a complaint about her from the victims of a business scam in her native country, who had heard she was wanted back in Miami on healthcare fraud. She was arrested that June in Medellin and later extradited from Bogota to Miami. Lavin, 55, was sentenced to 15 years in federal prison.
Last year, the FBI also tracked down Gonzalez’s father with cooperation from other South American authorities. Based on a tip, the FBI learned that he was traveling from Bolivia to Cuba, with a stop in Peru in 2011. The bureau asked Peruvian authorities to arrest him that October. He remained in jail until he was extradited in July 2012 to Miami.
Enrique Gonzalez, who had initially emigrated from Cuba in 2000, pleaded guilty to healthcare fraud and paying kickbacks to patients in a $26 million scam at two of the Benitez brothers’ HIV-therapy clinics. Gonzalez, 68, was sentenced to five years in prison.
His employers — Carlos, Jose and Luis Benitez — fled Miami after they were indicted in May 2008. The brothers got lucky, because they left while their indictments were still under seal. They used Cuban passports to travel from Miami to the Dominican Republic, then to Cuba.
The three brothers were charged with bilking the U.S. government’s health insurance program by billing $119 million in false claims for HIV-infusion treatments at 11 Miami-Dade clinics. The brothers pulled off the scam by hiring crooked doctors with Medicare numbers, hiring Cuban immigrants to register as clinic owners and paying $150-per-visit kickbacks to a network of Miami-Dade men with the AIDS virus who had valuable Medicare cards. About 20 defendants, including Carmen Gonzalez and her father, have been swept up in the Benitez brothers’ probe.
During the past decade, HIV-therapy exploded into the most spectacular swindle in Medicare history, with Health and Human Services, known for its lax oversight, paying out billions of dollars on phony claims for obsolete drug treatments that were mostly not provided to patients. The scam spun so out of control that Medicare-licensed clinics in South Florida billed more for this bogus therapy — more than the rest of the country combined.
For the Benitez brothers, the HIV-therapy scheme was a windfall: Medicare paid their clinics about $84 million between 2001 and 2004, according to their indictment.
The Benitezes, who came to this country in 1995 and became U.S. citizens five years later, have now found a safe haven in Cuba, according to sources familiar with their status. The FBI cannot pursue them or any other fugitives in Cuba because the United States does not have normal relations with the communist island nation.
But the brothers lost most of the property they had acquired in the Dominican Republic before they fled criminal prosecution in Miami. Federal authorities worked with the Dominican Republic to seize their extensive assets in the resort area of Bavaro, including a Pirates of the Caribbean-styled theme park.
Other assets included tourist hotels, a Robinson R44 Raven helicopter, apartment complexes, luxury homes, supermarkets and a rental car agency, all registered under shell companies or straw names. In 2011, Dominican authorities and the U.S. government announced a joint agreement to share seized Benitez properties and frozen bank accounts, totaling an estimated $37.5 million in forfeited assets. So far, the feds have recovered $14 million.
The Benitez brothers are not the only big fish still out there.
Another major fugitive: Jorge Emilio Perez, 49, the owner of an offshore remittance company called Caribbean Transfers. Perez was charged last year with financing a complex money-laundering ring that moved more than $30 million in stolen Medicare proceeds from South Florida through Canada into Cuba’s banking system — with the help of a check-cashing business operator, Oscar L. Sanchez, who pleaded guilty and was sentenced to four and a half years in prison.
Prosecutors described Caribbean Transfers as a sort of “Western Union” for money remittances. The company’s website says it specializes in remittance services to Cuba, the Dominican Republic and other countries.
The FBI suspects Caribbean Transfers’ owner is in the Dominican Republic.
The FBI’s Culp vowed that the bureau, which works with the Justice Department, Homeland Security and Interpol, will eventually track down Medicare offenders with outstanding arrest warrants.
Said Culp: “Fugitives may run, but they cannot hide.”
Medicare is a $536 billion federal program that provides health insurance to more than 50 million people — one in six Americans.
People aged 65 and older are automatically entitled to Medicare if they or their spouse are eligible for Social Security. People younger than 65 can qualify for Medicare if the Social Security Administration determines they are disabled. It is comprised of several parts to cover hospital services, outpatient care, managed care and prescription drugs.Fraud plagues Part B
In urban areas such as South Florida, fraud has plagued what is known as Part B, which makes up about 20 percent of Medicare’s annual budget. It covers claims submitted for outpatient care by physicians, clinic operators, home health agencies, medical equipment suppliers and others.