Medical Clinic Biller Convicted in Medicare Part C Fraud Scheme
| U.S. Attorney’s Office March 14, 2014 |
Wifredo A. Ferrer, United States Attorney for the Southern District of Florida; George L. Piro, Special Agent in Charge, Federal Bureau of Investigation (FBI), Miami Field Office; Brian P. Martens, Acting Special Agent in Charge, U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), Office of Investigations Miami Office; and Amy K. Parker, Assistant Special Agent in Charge, Office of Personnel Management, Office of Inspector General, announce that a federal jury found Cecilio Pelaez Delgado, 51, of Miami, guilty of 10 counts of health care fraud, in violation of Title 18, United States Code, Section 1347, and conspiracy to commit the same, in violation of Title 18, United States Code, Section 1349. Sentencing is scheduled for June 13, 2014 before U.S. District Judge Robert N. Scola, Jr.
According to the indictment and evidence admitted at trial, Pelaez Delgado was employed by a medical clinic, Viton Therapy Medical Center Inc. (Viton Therapy), a Florida corporation. Viton Therapy was an authorized medical services provider with Blue Cross and Blue Shield of Florida (BCBS) and Cigna, and was eligible to receive reimbursement from the private insurance carriers for medical services rendered to policyholders.
The evidence at trial demonstrated that Cecilio Pelaez Delgado, through Viton Therapy and another related clinic, One Solution Therapy, submitted and caused the submission of approximately $2.5 million in false and fraudulent claims for expensive infusion and injection therapies to the two insurance carriers, and was paid over $400,000 of the submitted claims. The evidence further established that the clinics paid kickbacks and bribes to beneficiaries suffering from HIV to ensure that they would attend the clinics.
Mr. Ferrer commended the investigative efforts of the FBI, HHS-OIG, and the Office of Personnel Management-Office of Inspector General. This case is being prosecuted by Assistant U.S. Attorney Christopher J. Clark.