Clinic Owners Sentenced to Prison in Connection with $5.4 Million Medicare Fraud

Miami residents, Marieva Briceno, 48, and her daughter, Karina Hernadez, 28, were sentenced yesterday in Detroit, Michigan to 60 months in prison and 36 months in prison, respectively, for their participation in a $5.4 million Medicare fraud scheme, announced the Department of Justice, FBI, and the Department of Health and Human Services (HHS).

United States District Judge Arthur J. Tarnow of the Eastern District of Michigan also sentenced Briceno and Hernandez to two years of supervised release following their respective prison terms and ordered them to pay approximately $2.9 million in restitution, jointly and severally with their co-defendants.

Briceno and Hernandez pleaded guilty on March 14, 2012, to one count of conspiring to commit health care fraud. According to the plea documents, beginning in approximately 2007, Briceno and Hernandez agreed to open three medical clinics in Livonia, Michigan: Blessed Medical Clinic, Alpha & Omega Medical Clinic, and Manuel Medical Clinic. Medicare beneficiaries, who went to the clinics, were paid to undergo medically unnecessary diagnostic tests. In exchange for cash and other consideration, the Medicare beneficiaries would sign documents indicating that they had received the services billed to Medicare. As a result, Medicare was billed $5.4 million for medically unnecessary diagnostic tests by the clinics associated with the scheme.

The sentencing 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 was prosecuted by Assistant U.S. Attorneys Frances Lee Carlson and Philip A. Ross of the Eastern District of Michigan, with assistance from Assistant Chief Gejaa T. Gobena of the Criminal Division’s Fraud Section. The investigation resulted in a total of nine guilty pleas and one conviction following a jury trial. 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 1,330 individuals who collectively have falsely billed the Medicare program for more than $4 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.