On Wednesday, it was announced that a Miami physician had been sentenced to 97 months in prison for his involvement in a $4.8 million health care fraud scheme. 51-year-old Roberto A. Fernandez of Miami was sentenced by Judge Cecelia M. Altonaga. As a part of the guilty plea, Fernandez admitted that he had referred Medicare beneficiaries to pharmacy owners in exchange for kickbacks. The defendant admitted to knowing that the pharmacy owners were billing and receiving reimbursements from Medicare for prescription drugs based on the prescriptions he sold.
He was also aware that many of his prescriptions were not medically necessary. The defendant confessed to providing prescriptions for many expensive, brand name drugs. Some of the HIV and AIDS drugs prescribed to the beneficiaries conflicted with other HIV drugs already prescribed to the patients. The defendant also confessed to submitting claims to Medicare under his Part B provider number for services that he did not actually provide.
Fernandez admitted that he had received kickbacks in exchange for signing plans of care and prescriptions for home health services that were not medically necessary. Fernandez also admitted to prescribing controlled substances to patients and patient recruiters in exchange for cash. The defendant was often paid $100 or $200 in cash for each prescription. Fernandez admitted he was aware that the patients did not need the controlled substances that he had prescribed.
He had also written prescriptions for controlled substances for patients he had never examined. As a result of his actions, Roberto A. Fernandez has been sentenced to 97 months in prison along with three years of supervised release. Judge Altonaga has ordered the defendant to pay $4.8 million in restitution as well.