Thursday, July 24, 2008

Money & Business

The Collar by Luke Mullins

Big Sentence for Medicare Fraudster

April 03, 2008 02:59 PM ET | Luke Mullins | Permanent Link

Rita Campos Ramirez, a 60-year-old Miami resident, received a 10-year prison sentence for her role in a multimillion-dollar Medicare fraud scheme. The $170 million scheme is the program's largest individual case of fraud ever. The sentence was announced Wednesday.

As part of her punishment, Ramirez will also have to hand over her three homes and a car. Plus, she was ordered to pay $105 million in restitution to the federal government.

"The sentence in this case dispels the myth that white-collar-crime defendants get off lightly," FBI Special Agent in Charge Jonathan Solomon said in a press release. "It reinforces the message that healthcare fraud—stealing from U.S. taxpayers—is a serious crime."

Details of the crime:

Campos pleaded guilty on Aug. 28, 2007, to one count of conspiracy to commit health care fraud and one count of submitting false claims to Medicare. As part of her plea, Campos admitted that between October 2002 and April 2006 she owned and operated R&I Medical Billing Inc., a medical billing company that specialized in submitting bills to the Medicare program on behalf of HIV infusion clinics. Campos admitted that she knowingly submitted approximately $170 million in fraudulent medical bills to Medicare on behalf of 75 HIV infusion clinics in Miami-Dade County that were part of the scheme. Infusion clinics serve HIV patients by providing prescribed medications intravenously.

The Medicare program paid approximately $105 million of the $170 million in fraudulent bills submitted by Campos, with Campos personally receiving $5 million for her role in the fraud.

Full press release is here.

Tags: Medicare | prison sentences

Tools: Share | | Comments (3)

Reader Comments

I'm not surprised that this has happened. I am only surprised that this does not happen more often.

medicare fraud

I'm glad to hear Medicare is finally disapproving of fraudulent claims. When I reported fraudulent claims submitted by a physical therapy provider and a physician serving a nursing home, Medicare insisted on paying the claims and told me "it's not our policy to question any claims that are submitted to us". Any surprise that we're being told the program is going to run out of money?

Medicare Fraud

I am an Educator and a Program Manager for a well known school and I am always telling my students about medicare fraud and abuse. This is an excellent example that you will be exposed and you will go to jail. As a coder I feel this makes it worst for us who are good coder's and uphold the laws.

Add your thoughts

All comments are moderated and generally will be posted if they are on-topic and not abusive. For more information, please see our Comments FAQ.

advertisement

Luke Mullins is an associate editor at U.S. News, covering banking, real estate, and white-collar crime. He came to the magazine from the American Banker, a financial services daily newspaper, after a stint in the Peace Corps in West Africa and 18 months coaching baseball in the Dominican Republic. Mullins earned a master's degree in journalism from Syracuse University in 2005 and now lives in Washington, D.C., where he grew up. He has written about white-collar criminals for the American magazine, and his work was included in 20 Something Essays by 20 Something Writers: The Best New Voices of 2006, a Random House anthology that appeared on the Boston Globe's bestseller list.

advertisement

NEWSLETTER

Sign up today for the latest headlines from U.S. News & World Report delivered to you free.

RSS FEEDS

Personalize your U.S. News with our feeds of blogs and breaking news headlines.

U.S. NEWS MOBILE

U.S. News daily briefings are also available on your mobile device.

Use of this Web site constitutes acceptance of our Terms and Conditions of Use and Privacy Policy.