Miami Couple Sentenced to Imprisonment in $1 Million Health Care Fraud Conspiracy

SAVANNAH, GA—Edward J. Tarver, United States Attorney for the Southern District of Georgia, announced that Fernando Alfonso and Rita Mateu, both residents of Miami, Florida, were recently sentenced by Chief United States District Judge William T. Moore, Jr. based on their convictions for conspiracy to commit health care fraud in violation of Title 18, United States Code, Section 371. Alfonso was sentenced to 30 months’ imprisonment, while Mateu was sentenced to 46 months’ imprisonment. Alfonso and Mateu will be required to serve a three-year period of supervised release following completion of their prison sentence.

The case against Alfonso and Mateu resulted from a joint investigation by the Federal Bureau of Investigation (“FBI”) in conjunction with the Health and Human Service Office of Inspector General (“HHS-OIG”). The evidence at the guilty plea hearing for both defendants showed that from December 2007 through April 2008, Alfonso and Mateu conspired to bill approximately $1 million in fraudulent infusion claims to Medicare for Towne Lake Rehab and Medical Center, LLC, a clinic located in Woodstock, Georgia, which provided infusion therapy services to Medicare beneficiaries. The evidence showed that Mateu and Alfonso, with the assistance of others, conspired to defraud Medicare by: recruiting Medicare beneficiaries from local homeless shelters by offering these homeless people food or money in exchange for their Medicare information; stealing the identities of local medical doctors in order to bill Medicare; and using the stolen identities and Medicare beneficiary information to submit over $1 million dollars of phony infusion therapy bills to Medicare for medical services that were never actually provided.

United States Attorney Tarver stated, “This office will continue to work closely with our federal partners to ensure that those who target our Medicare program are themselves targets of criminal prosecution.”

Mr. Tarver praised the cooperative efforts of Special Agents Mark A. Alig and Joshua Hayes of the FBI, along with Special Agent David Graupner of HHS-OIG, who led the investigation of this matter. Mr. Tarver noted that the indictment against Alfonso and Mateu arose out of Operation Redex Infuscam, a major investigation by the FBI and HHS-OIG into fraudulent infusion billings to Medicare in and around the Southern District of Georgia.

The government was represented by Brian T. Rafferty, Chief of the Criminal Division for the United States Attorney’s Office for the Southern District of Georgia.