October 10, 2014

Three Florida Residents are Charged with Health Care Fraud, Money Laundering, and Drug Trafficking

WASHINGTON—Three Miami residents have been charged in a superseding indictment with health care fraud violations stemming from a $23 million Medicare fraud scheme. Two of the defendants are also charged with drug trafficking for submitting fraudulent prescriptions for oxycodone and other drugs to pharmacies.

Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida, Special Agent in Charge George L. Piro of the FBI’s Miami Field Office and Acting Special Agent in Charge Derrick Jackson of the U.S. Department of Health and Human Services Office of Inspector General’s (OIG-HHS) Miami Regional Office made the announcement.

On Oct. 9, 2014, a grand jury sitting in the Southern District of Florida returned a 16-count superseding indictment, charging Guillermo Delgado, 45; Gabriel Delgado, 42; and Emerson Carmona, 43, with conspiracy to pay and receive health care kickbacks and the receipt of kickbacks. Guillermo Delgado and Gabriel Delgado were also charged with conspiracy to commit money laundering, and Gabriel Delgado was charged with four money laundering counts. In addition, Guillermo Delgado and Emerson Carmona were charged with conspiracy to commit health care fraud and conspiracy to possess with intent to distribute a controlled substance.

The superseding indictment alleges that Jose Carlos Morales, 57, co-owned two pharmacies, Pharmovisa Inc., Pharmovisa Limited, and PharmovisaMD Inc. Between March 2006 and September 2012, Morales paid kickbacks to brothers Guillermo Delgado and Gabriel Delgado, as well as Carmona, for Medicare beneficiary information, which Morales then used to submit more than $23 million in fraudulent claims to Medicare and Medicaid. The Delgado brothers allegedly concealed the kickbacks by disguising them as legitimate payments for services purportedly provided by shell companies under their control.

The superseding indictment also alleges that from June 2010 through September 2011, Guillermo Delgado and Carmona delivered or caused the delivery of fraudulent prescriptions for oxycodone, oxymorphone and other prescription drugs to Morales’s pharmacies. Morales filled the fraudulent prescriptions and submitted fraudulent claims for reimbursement to Medicare. Guillermo Delgado and Carmona allegedly gave the drugs to other co-conspirators for resale.

On Dec. 7, 2012, Morales pleaded guilty to one count of conspiracy to commit health care fraud and one count of conspiracy to defraud the United States and pay illegal health care kickbacks. On Feb. 26, 2013, he was sentenced to serve 14 years in prison.

The charges contained in the superseding indictment are merely accusations, and the defendants are presumed innocent unless and until proven guilty.

This case was investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida. This case is being prosecuted by Trial Attorney Allan J. Medina of the Criminal Division’s Fraud Section.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged nearly 2,000 defendants who have collectively billed the Medicare program for more than $6 billion. In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

To learn more about the Health Care Fraud Prevention and Enforcement Team (HEAT), go to: www.stopmedicarefraud.gov.