Jury Convicts Miami Clinic Owner in $24 Million HIV-Infusion Fraud

Wifredo A. Ferrer, United States Attorney for the Southern District of Florida, and John V. Gillies, Special Agent in Charge, Federal Bureau of Investigation, Miami Field Office, announced that on Wednesday, July 21, 2010, defendant Raul S. Ramirez, 55, of Miami Gardens, Florida, was convicted of one count of conspiracy to commit health care fraud, 12 counts of health care fraud, and three counts of money laundering.

According to the evidence presented at trial, the fraud involved purported treatment of HIV- positive Medicare beneficiaries at RA Medical Center, 2455 W. Flagler St., Miami, Florida. Ramirez paid Medicare beneficiaries to sign papers as though they had received treatment and to allow their Medicare numbers to be used to bill Medicare.

The billings were mostly for expensive drug infusion treatments for blood disorders that were claimed to be complications of the beneficiaries’ HIV condition. To justify the treatments, Ramirez caused the falsification of medical records showing severe symptoms such as spontaneous bleeding. Also, the blood samples from Ramirez’ clinic were found to be fraudulent. Blood tests from the same Medicare beneficiaries at legitimate hospitals did not show the purported blood disorders.

Ramirez hired billing companies to bill Medicare, and had the bills submitted under the name of an elderly doctor, now deceased. The doctor traveled weekly to New York where he had a general medicine practice. The doctor was not in Miami on the dates of many of the doctor visits and treatments billed to Medicare.

Ramirez caused approximately $24 million in fraudulent Medicare claims to be submitted and obtained approximately $6.9 million. Ramirez deposited the Medicare funds into bank accounts that he controlled. He was convicted of money laundering counts related to his withdrawals of millions of dollars of the fraud proceeds for his own benefit.

Prior to the criminal trial, approximately $4.9 million was recovered in a civil forfeiture case. Also, based on the jury’s forfeiture verdict in the criminal trial, Ramirez will be ordered to forfeit an additional $960,688.54.

Sentencing has been scheduled for October 13, 2010. Ramirez faces a maximum sentence of ten (10) years’ imprisonment on each of the 16 counts.

Special Agent in Charge John V. Gillies stated, “Criminals who commit health care fraud steal from all of us as U.S. taxpayers and in the end make medical care more expensive for all us. The FBI will continue to work with our partners to combat this crime problem.”

Mr. Ferrer commended the investigative efforts of the Federal Bureau of Investigation. This case is being prosecuted by Assistant U.S. Attorneys Ana Maria Martinez and Norman O. Hemming, III.

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 http://pacer.flsd.uscourts.gov.