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3 Miami Residents Charged with Medicare Fraud

More People in Miami Charged with Medicare Fraud

medicare fraudFlorida is the stereotypical home of millions of retirees, which means that the state is also home to the most Medicare fraud in the country.

On Thursday, October 9th, three Miami residents were charged for their roles in a $23 million Medicare fraud scheme. Guillermo Delgado (45), Gabriel Delgado (42), and Emerson Carmona (43), faced numerous federal charges including conspiracy to pay and receive healthcare kickbacks, money laundering, healthcare fraud and conspiracy, and possession with intent to distribute controlled substances.

The three men were indicted as part of a larger indictment against Jose Carlos Morales (57), who ran Pharmovisa Inc, Pharmovisa Limited, and PharmovisaMD Inc between March 2006 and September 2012. According to the Medicare fraud indictment, Morales paid kickbacks the Delgados as well as Carmona in exchange for Medicare beneficiary information, which Morales then used to submit $23 million in fraudulent claims to the Medicare / Medicaid program. The Delgados created shell companies to make the kickback payments look like legitimate healthcare payments.

The indictment also covers charges involving an illegal prescription drug ring that Guillermo Delgado and Carmona ran, in which the two delivered fraudulent prescription requests for powerful narcotic painkillers like oxycodone, oxymorphone, and other drugs to Morales’s pharmacies. Morales filled the fraudulent prescriptions at the expense of the Medicare program, then Delgado and Carmona took the drugs to other co-conspirators for resale.

Morales was sentenced to 14 years in prison in February 2013 for his part in running the Medicare fraud conspiracy.

Whistleblower Protections and Medicare Fraud Claims

Qui Tam” are the first words of a Latin clause referring to the plaintiff as “one who sues as much for the state as for himself or herself.”

It is a provision of the Federal Civil False Claims Act that allows a private citizen to file a suit, in the name of the U.S. Government, charging fraud by government contractors and other entities that receive or use government funds. Bolstered by amendments passed by Congress in 1986, the law has armed private citizens who have independent and direct knowledge of fraud, whether financial institution fraud or Medicare fraud, with a weapon to prosecute government contractors and others who are defrauding the Government.

Common whistle blower actions include:

  • Medicare fraud,
  • defense contractor fraud, and
  • other kinds of fraud against state or federal government

Qui tam lawsuits have been, and continue to be, a very effective and successful tool in combating government procurement and program fraud.

The Strom Law Firm Can Help Protect Medicare Fraud Whistleblowers with the False Claims Act

If you are personally aware of a fraud that has been committed by your current or former employer, a competitor or otherwise, from tax evasion to Medicare fraud, contact the Qui Tam attorneys at the Strom Law Firm today for a no cost consultation to discuss the facts of your case and whether filing a qui tam may be appropriate. We understand the complexity of the False Claims Act, and can help you with your case. We offer free, confidential consultations so contact us for help today. 803.252.4800



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