You are currently viewing Mother and Son Guilty For $16 Million Medicare Fraud Scheme

Mother and Son Guilty For $16 Million Medicare Fraud Scheme

A mother and son based in Miami each pleaded guilty today to fraud charges for their roles in a $16 million Medicare fraud scheme.

Niurka Fernandez, 54, and Roberto Alvarez, 29, both of Miami, each pleaded guilty to one count of conspiracy to commit health care fraud before U.S. District Judge Federico A. Moreno of the Southern District of Florida. The sentencings have been scheduled for Nov. 8, 2016, before Judge Moreno.

As part of her guilty plea, Fernandez admitted that she was an owner of Calan Pharmacy & Discount Service LLC (Calan Pharmacy) and Bertyann Corp., doing business as Best Pharmacy, two pharmacies located in Miami-Dade County, Florida. Fernandez was an organizer and leader of a Medicare fraud scheme that paid Medicare beneficiaries and patient recruiters for prescriptions that were medically unnecessary, according to the plea agreement. Fernandez also admitted that she and her co-conspirators at Calan Pharmacy and Best Pharmacy billed Medicare for many prescription medications that they never even dispensed to the beneficiaries.

In connection with his guilty plea, Alvarez admitted that he was involved in the Medicare fraud scheme at Best Pharmacy. Alvarez purported to work at best Pharmacy as a pharmacy technician, but in fact facilitated kickback payments to medicare beneficiaries, according to the plea agreement. While at Best Pharmacy, Alvarez wrote checks to money launderers in order to obtain cash to pay the kickbacks to the medicare beneficiaries, he admitted.

Medicare made more than $16 million in overpayments to Calan Pharmacy and Best Pharmacy as a results of the health care fraud scheme, according to admission made in connection with yesterday’s pleas.