Eight Miami Residents Charged in Five-State $100 Million Medicare and Medicare Advantage Fraud Scheme

Jeffrey H. Sloman, Acting United States Attorney for the Southern District of Florida, Jonathan I. Solomon, Special Agent in Charge, Federal Bureau of Investigation, Miami Field Office, Daniel W. Auer, Special Agent in Charge, Internal Revenue Service, Criminal Investigation Division, and Al Lamberti, Broward County Sheriff, announced that defendants Michel De Jesus Huarte, 38, Ramon Fonseca, 45,Vicente Gonzalez, 38, Alyd Dazza, 45, Monika Blacio, 41, Ricco Dazza, 41, Orlin Tamayo Quinonez, 35, and Juan Carralero, 56, all residents of Miami, FL, were indicted on June 18, 2009, on Medicare and other fraud-related charges.

More specifically, defendants Vicente Gonzalez, Alyd Dazza, Rico Dazza, and Monika Blacio were charged with conspiracy to commit Medicare fraud and/or conspiracy to commit money laundering. They are scheduled to be arraigned today at 1:30 PM before Magistrate Judge Patrick White. Two other defendants, Michel De Jesus Huarte and Ramon Fonseca, were arraigned yesterday on charges of conspiracy to commit Medicare fraud, Medicare fraud, conspiracy to commit money laundering, money laundering, and aggravated identity theft. Defendants Orlin Tamayo Quinonez and Juan Carralero, both charged with conspiracy to commit Medicare fraud, have not yet been arrested and remain at large. The Indictment also seeks the forfeiture of the fraud proceeds.

The 20-count Indictment charges two separate Medicare fraud conspiracies. The first conspiracy charges that defendant Michel De Jesus Huarte and unindicted conspirators controlled and operated six purported medical clinics in Miami-Dade County: Zigma Medical Care, Inc.; Tender Loving Care Medical Center, Inc.; Professional Medical Health, Inc.; Metro Med Care, Inc.; San Diego Medical & Rehab Center, Inc.; and Eulogia's Diagnostic Medical Center, Inc. According to the Indictment, these clinics submitted at least $50.2 million in false claims to Medicare for infusion therapy, injection therapy, and other expensive medical treatments designed to treat patients suffering from, among other illnesses, cancer, HIV, AIDS, chronic pain, and varicose veins. Infusion therapy medications are administered by insertion of a needle into a patient's vein.

As a result of these fraudulent infusion claims, Medicare paid Huarte and his conspirators at least $19.2 million. To conceal his involvement in this scheme, Huarte and his conspirators recruited nominee owners for each company, and paid them large sums of cash to sign the corporate records, bank records, and other business documents. One such nominee owner, Madelin Machado of Zigma Medical, was indicted in the Southern District of Florida in January 2008 (Case No. 08-20033-HUCK), and remains a fugitive.

The second Medicare fraud conspiracy charges defendants Michel De Jesus Huarte, Ramon Fonseca, Vicente Gonzalez, Monika Blacio, Ricco Dazza, Orlin Tamayo Quinonez, and Juan Carralero in a five-state Medicare Advantage fraud scheme. This conspiracy charge alleges that Huarte and Fonseca controlled and operated eight (8) medical clinics purportedly operating in Florida, Georgia, Louisiana, North Carolina, and South Carolina. These companies are alleged to have collectively submitted at least $19.8 million in false claims to various private insurance companies that offered coverage to Medicare beneficiaries through Medicare Advantage programs.

The Medicare Advantage Program, formerly known as "Part C" or "Medicare+Choice," provides Medicare beneficiaries with the option of receiving their Medicare benefits through private managed care plans, including health maintenance organizations (HMOs), provider sponsored organizations (PSOs), preferred provider organizations (PPOs), and private fee-for-service plans (PFFs), rather than through traditional Medicare (Parts A and B). Based on the false claims received, these companies paid the defendants approximately $4.6 million. Once again, a substantial portion of the fraudulent billings were for expensive cancer and HIV infusion medications.

The Indictment further alleges that defendants Vicente Gonzalez and others formed and managed the two purported clinics in New Orleans: Fast Cure and Best Cure. Defendants Monika Blacio, Ricco Dazza, and Orlin Tamayo Quinonez allegedly formed and managed Ziallet Services, Inc. in North Carolina, and Magestic Group Services, Inc., in South Carolina. Juan Carralero allegedly served as the titular owner of two Georgia clinics, Comprehensive Medicare Care Services, Inc. and Best Care Solutions Corp., and helped manage and operate both companies.

The Indictment alleges that Huarte and Fonseca deposited fraud proceeds from their clinics at two Miami-area check cashing stores, Universal MoneyFast and Rapid Trans Solutions. These check cashing stores were owned by defendants Alyd Dazza and Monika Blacio, respectively. Defendants Alyd Dazza and Blacio would accept delivery of Medicare Advantage insurance company checks from Huarte and Fonseca as often as three to four times per week. Thereafter, Dazza and Blacio would deposit the checks into the corporate bank accounts for their respective check cashing stores, wait for the checks to clear, and then deliver the cash to Huarte and/or Fonseca. The typical cash deliveries ranged from between $30,000 and $80,000 multiple times per week. This conduct resulted in the money laundering conspiracy charges against defendants Huarte, Fonseca, Gonzalez, Blacio, and Dazza.

Acting U.S. Attorney Jeffrey H. Sloman stated, "With new Medicare fraud cases being indicted in the Southern District of Florida every week, it is easy to become numb to otherwise egregious fraudulent conduct and staggering loss amounts. This case is remarkable, not only in terms of the amounts stolen from Medicare, but also in terms of its sophistication and geographic breadth. These defendants attempted to steal approximately $100 million from the elderly, blind and disabled by using multiple store-front clinics in five different states and then laundered their profits through local check cashing stores. The U.S. Attorney's Office will continue to devote significant prosecutorial resources to aggressively eliminate these abuses, and to send the perpetrators to jail."

"The FBI and its partners will continue to investigate those who steal from taxpayers by committing health care fraud. We are confident that law enforcement, combined with preventive measures, can make a difference in substantially reducing health care fraud," said Jonathan I. Solomon, Special Agent in Charge of the Miami Office of the FBI.

"The IRS plays a critical role in the investigation of financial crimes cases by providing the financial expertise to follow the money trail and helping to seize the profits of illegal activities. This case is another example of the successes that occur when federal and local law enforcement combine resources," said Daniel W. Auer, Special Agent in Charge of the IRS-Criminal Investigation Division.

Broward Sheriff Al Lamberti stated, "Cases such as this are the reason behind the creation of the Broward County Money Laundering Task Force. I commend everyone involved for successfully navigating such a complex, multi-agency investigation."

If convicted, the defendants face a possible maximum statutory sentence of 10 years' imprisonment on each count of conspiracy to commit health care fraud and each count of substantive health care fraud, 10 years' imprisonment on each count of conspiracy to commit money laundering and substantive money laundering, and 2 years' imprisonment on each count of aggravated identity theft.

Mr. Sloman commended the cooperative investigative efforts of the Federal Bureau of Investigation, the Internal Revenue Service, and the Broward County Sheriff's Office. This case is being prosecuted by Assistant U.S. Attorney Ryan Stumphauzer.

A copy of this press release may be found on the website of the United States Attorney's Office for the Southern District of Florida at www.usdoj.gov/usao/fls. Related court documents and information may be found on the website of the United States District Court for the Southern District of Florida at www.flsd.uscourts.gov or on http://pacer.flsd.uscourts.gov .