The Collar

Big Sentence for Medicare Fraudster

By Luke Mullins

Posted: April 3, 2008

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.

Rita Campos Ramirez

I think the doctors submitting the fraudulent charges should be held accountable not the person who bills exactly what the doctor tells her to.

Sally Wride of FL @ Jun 09, 2009 16:48:11 PM

Medicare Fraud

I am pleased to hear that this woman was caught. I guess now she will see what it is like to live like a "normal broke person" and maybe if she weren't stealing she could've done that without owing the government over $1 million. She lived a pampered life due to her theft and it makes me wonder how she viewed the rest of society while on her high horse and honest people are working hard for their one home and maybe 2 cars if we're lucky. I put myself through school to get my MBA and I owe thousands of dollars in student loans but I live an honest life and if I have to live pinching pennies I'd rather do that than steal.

of VA @ Apr 11, 2008 11:41:06 AM

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.

Monique Blake McMiller of GA @ Apr 05, 2008 20:34:14 PM

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The Collar

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.

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