Clinic Owners Sentenced for Roles in $13.3 Million Medicare Fraud Scheme

WASHINGTON—Miami residents Raymond Arias, 42, and his wife, Emelitza Arias, 25, have been sentenced in Detroit to 100 months and 12 months in prison, respectively, for their participation in a $13.3 million Medicare fraud scheme.

Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division; U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade; Special Agent in Charge Robert D. Foley, III of the FBI’s Detroit Field Office; and Special Agent in Charge Lamont Pugh, III of the U.S. Department of Health and Human Service’s Office of Inspector General’s (OIG) Chicago Regional Office, made the announcement after sentencing by U.S. District Paul D. Borman of the Eastern District of Michigan.

The Ariases were also sentenced to two years of supervised release following their respective prison terms. At sentencing on May 7, 2013, the court ordered Raymond Arias to pay $5.4 million in restitution. Today at sentencing, the court ordered Emelitza Arias to pay $531,883 in restitution, jointly and severally. The defendants agreed to forfeit approximately $40,000 seized by federal agents during the investigation.

The Ariases pleaded guilty on October 17, 2012, to one count of conspiring to commit health care fraud. According to the plea documents, beginning in approximately 2009, Raymond Arias opened Elite Wellness where he submitted claims to Medicare for infusion therapy treatments that were never rendered. In three months, Elite Wellness submitted in excess of $10 million in claims to Medicare. Emelitza Arias joined the scheme by opening a second clinic, Carefirst Physical Therapy & Rehabilitation Center, which submitted approximately $940,000 in claims to Medicare for infusion therapy treatments that were never rendered.

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. This case was prosecuted by Trial Attorney Catherine Dick of the Criminal Division’s Fraud Section and Assistant U.S. Attorney Philip A. Ross of the Eastern District of Michigan.

Since their inception in March 2007, the Medicare Fraud Strike Force operations in nine districts have charged more than 1,480 individuals who collectively have falsely billed the Medicare program for more than $4.8 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.

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