February 27, 2014: Four Individuals Indicted and Arrested for Health Care Fraud
Food and Drug Administration
Office of Criminal Investigations
U.S. Department of Justice Press Release
For Immediate Release
February 27, 2014
United States Attorney
District of Puerto Rico
Contact: Lymarie V. Llovet-Ayala
Public Affairs Specialist
(787) 766-5656; (787) 340-1835
SAN JUAN, P.R. - Yesterday, February 26, a Federal grand jury returned a fourteen count-indictment against four individuals for health care fraud and causing the misbranding and adulteration of prescription medications with intent to mislead and defraud, announced Rosa Emilia Rodriguez-Velez, United States Attorney for the District of Puerto Rico. The defendants are facing a forfeiture allegation of $225,929.21.
According to the indictment, from on or about January 1, 2010 through on or about September 24, 2011, Family Pharmacy submitted at least 554 false and fraudulent claims to Medicare, through MCS, totaling approximately $309,456.81, seeking reimbursement for adulterated/misbranded Levalbuterol and Budesonide, causing Medicare, through MCS, to disburse approximately $225,929.21.
Defendant Francisco A. Rivera-Gonzalez was the President and owner of Family Pharmacy, located in the Municipality of Anasco, PR. As part of the business activities of Family Pharmacy he submitted claims to Medicare, through MCS Classicare. Rivera-Gonzalez caused the adulteration/misbranding of Levalbuterol and Budesonide provided to Medicare beneficiaries and subsequently billed to Medicare. Luis Roberto Jimenez-Feliciano was the owner and president of RJ Medcare, Inc. He facilitated and caused the adulteration/misbranding of Levalbuterol and Budesonide provided to Medicare beneficiaries.
Defendant Francisco J. Cintron-Acevedo was a licensed pharmacist and owner of Farmacia Cintron, located in the municipality of Utuado, PR., and the Resident Agent in Charge of Franseb Inc. Cintron-Acevedo facilitated and caused the adulteration/misbranding of Levalbuterol and Budesonide provided to the Medicare beneficiaries which were subsequently billed to Medicare. Defendant Derilyn Serrano-Bernacet was a pharmacy technician at Farmacia Cintron. She illegally compounded Levalbuterol and Budesonide provided to Medicare beneficiaries, which were subsequently billed to Medicare.
"As part of the nation's health care system, Medicare serves vulnerable citizens, specifically our elderly," said United States Attorney, Rosa Emilia Rodriguez-Velez. "Today's arrests show that we will not tolerate criminals who engage in fraudulent schemes which threaten and harm people's lives and deplete the Medicare program of funds which are destined for our senior citizens, in order to enrich themselves."
"The Food and Drug Administration, Office of Criminal Investigations will continue to vigorously protect the health and safety of consumers from misbranded or adulterated drugs," said Ralph Culkin, Resident Agent in Charge of FDA, Office of Criminal Investigations in Puerto Rico.
"HHS-OIG will continue to support these types of investigations, especially when misbranded and adulterated drugs pose a threat to the public and are billed to the Medicare program", said Thomas O'Donnell, Special Agent in Charge of the Office of Inspector General's New York Regional Office which also covers Puerto Rico.
The investigation was led by the Food and Drug Administration-Office of Criminal Investigations, with the collaboration of the Department of Health and Human Services, Office Of the Inspector General (HHS-OIG).
The case is being prosecuted by Special Assistant U.S. Attorney Wallace A. Bustelo. If found guilty, the defendants could face a possible sentence of (10) years in prison for the Health Care Fraud offense and fines of up to $250,000. A criminal indictment contains only charges and is not evidence of guilt. Defendants are presumed to be innocent unless and until proven guilty.
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