Patient Recruiter Pleads Guilty in Connection with $5.4 Million Medicare Fraud Scheme in Detroit

WASHINGTON—A patient recruiter pleaded guilty today for his participation in a Medicare fraud scheme operated out of three Detroit-area health care clinics, announced the Department of Justice, the FBI and the Department of Health and Human Services (HHS).

Santiago Villa-Restrepo, 33, 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, Villa-Restrepo faces a maximum penalty of 10 years in prison and a $250,000 fine.

According to the plea documents, Villa-Restrepo recruited Medicare beneficiaries for three Detroit-area health care clinics owned by co-conspirators. In exchange for cash bribes paid by Villa-Restrepo and others, the beneficiaries agreed to attend the clinics where they provided their Medicare provider numbers and other information, which allowed the clinics to bill for diagnostic tests that were medically unnecessary, and in some cases, not provided at all. According to court documents, Medicare was billed $5.4 million for medically unnecessary diagnostic tests by the clinics associated with the scheme.

Today’s guilty plea was announced by Assistant Attorney General Lanny A. Breuer of the 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.