Miami-Dade County

Young Miami man gets nine years for stealing $21 million from Medicare

For Daniel Suarez, Medicare fraud was a family affair.

Suarez ran a ring of relatives who robbed $21 million from the taxpayer-funded Medicare program by using a network of Miami-Dade pharmacies to submit phony claims for costly prescription drugs.

On Wednesday, the convicted pharmacy technician, who emigrated from Cuba to the United States as a teenager, was sentenced to nine years in prison — significant punishment, but less than the 14 years federal prosecutors thought he deserved.

Suarez, 24, was also ordered to pay back the millions of dollars he stole from Medicare. He spent some of the ill-gotten funds on a couple of suburban homes and a fleet of luxury cars, including a Rolls Royce Ghost and a Bentley.

In September, Suarez pleaded guilty to a conspiracy to commit healthcare and wire fraud for his leading role in an indictment that named several other family members as defendants, including his mother and aunt, who also cut plea deals.

“To date, Suarez has refused to provide an accounting of the $21 million he stole and has done nothing to assist the government in recovering assets,” federal prosecutor Roger Cruz wrote in a court filing this week. “In fact, post-arrest, Suarez continued to dissipate assets he purchased with fraud proceeds.”

Suarez’s defense attorney, Frank Quintero, was seeking a lower sentence from U.S. District Judge Donald Middlebrooks. Quintero argued that his client was responsible for stealing $5.5 million from the Medicare program, which the judge rejected as a loss amount.

Quintero also argued that Suarez had never been in trouble with the law until he was manipulated by his aunt to get involved in her Miami-Dade pharmacy business.

Quintero wrote in court papers that “Mr. Suarez’s whole life has revolved around his family. Unfortunately, due to his young age and sense of familial duty, Mr. Suarez allowed himself to be involved in the instant conspiracy.”

Suarez was charged with 11 other defendants in an indictment accusing him and others of paying patient recruiters and patients for their Medicare ID numbers and submitting false claims for prescription drugs through eight pharmacies — medication that was not needed or provided.

In June, Suarez and the others were among more than 70 South Florida suspects charged in Miami federal court with bilking Medicare, including dozens accused of defrauding the Part D prescription drug program that was implemented a decade ago during the Bush administration.

U.S. Attorney Wifredo Ferrer said the regional sweep was part of the largest-ever national Medicare fraud take-down in the past decade, with the South Florida defendants accounting for about one-third of all suspects rounded up.

Since its inception in 2006, the Part D program has gained popularity because it helps deliver prescription drugs to nearly 40 million elderly and disabled Americans, who buy them from pharmacies reimbursed by private insurers funded by Medicare. But predictions of potential fraud in the program — which accounts for just over 10 percent of Medicare spending — have turned out to be accurate because numerous pharmacies submit false prescriptions for anti-depressant, anti-inflammatory and other drugs.

In several of the latest criminal cases in Miami, pharmacy owners paid kickbacks to patient recruiters and patients to generate a steady stream of bogus Medicare claims to fleece the Part D program. That has been a longstanding practice in South Florida's Medicare rackets, which have billed for a host of unused services from medical equipment to HIV infusion therapy to mental health sessions.

Among the South Florida criminal cases filed in June, some clinic operators also sold batches of fabricated prescriptions that Medicare patients didn't even know about — distributing them like a "drive-thru" business, authorities say, to be used for filing fraudulent claims.

In 2013, ProPublica reporters highlighted the vulnerability of Medicare’s Part D program, noting that insurance companies must pay for prescriptions issued by any licensed prescriber and filled by any willing pharmacy within 14 days.