Detroit-Area Clinic Owner Pleads Guilty in Connection with Medicare Fraud Scheme
|U.S. Department of Justice December 06, 2011|
WASHINGTON—A clinic owner pleaded guilty today for her participation in a Detroit-area Medicare fraud scheme, announced the Department of Justice, the FBI and the Department of Health and Human Services (HHS).
Dora Binimelis, 53, of Miami, pleaded guilty before U.S. District Judge Arthur J. Tarnow in the Eastern District of Michigan to one count of conspiracy to commit health care fraud. At sentencing, Binimelis faces a maximum penalty of 10 years in prison and a $250,000 fine.
According to the plea documents, Binimelis was an owner of Blessed Medical Clinic, which purported to be a medical clinic that specialized in diagnostic testing. Binimelis admitted that the clinic defrauded Medicare by billing for expensive and medically unnecessary tests. The owners and operators of Blessed paid patient recruiters, who paid cash bribes to Medicare beneficiaries. In exchange for the cash bribes, the beneficiaries agreed to attend the clinic where they provided their Medicare provider numbers and other information, which was used to bill Medicare for unnecessary tests and services. According to her plea, Binimelis knew that the purpose of the clinic was not to treat sick patients, but to make money by defrauding Medicare. Binimelis provided diagnostic testing equipment and the capital infusion to open Blessed. In exchange for her contributions, she received a share of the Medicare fraud proceeds. According to court documents, Blessed billed Medicare $2.4 million for medically unnecessary diagnostic tests.
Today’s guilty plea was announced by Assistant Attorney General Lanny A. Breuer of the Justice Department’s Criminal Division; U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade; Special Agent in Charge Andrew G. Arena of the FBI’s Detroit Field Office; and Special Agent in Charge Lamont Pugh III of the HHS Office of Inspector General’s (OIG) Chicago Regional Office.
This case is being prosecuted by Assistant U.S. Attorney Philip A. Ross of the Eastern District of Michigan, with assistance from Acting Assistant Chief Benjamin D. Singer of the Criminal Division’s Fraud Section. The case was investigated by the FBI and HHS-OIG, and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan.
Since their inception in March 2007, the Medicare Fraud Strike Force operations in nine districts have charged more than 1,140 individuals who collectively have falsely billed the Medicare program for more than $2.9 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.