DETROIT MEDICARE FRAUDSTER PLEADS GUILTY TO ROLE IN $5.4 MILLION SCHEME

The following excerpt is from the Department of Justice website:
Wednesday, March 14, 2012
Three Detroit-Area Clinic Owners Plead Guilty for Their Roles in $5.4 Million Medicare Fraud Scheme
WASHINGTON – Three Detroit-area clinic owners pleaded guilty today for their participation in a Medicare fraud scheme, announced the Department of Justice, the FBI and the Department of Health and Human Services (HHS).  

Karina Hernandez, 28, Marieva Briceno, 46, and Henry Briceno, 58, all of Miami, pleaded guilty before U.S. District Judge Arthur J. Tarnow in the Eastern District of Michigan to one count of conspiracy to commit health care fraud.  At sentencing, each defendant faces a maximum penalty of 10 years in prison and a $250,000 fine.      

According to the plea documents, Hernandez managed the daily operations of three Livonia, Mich., clinics: Blessed Medical Clinic, Alpha & Omega Medical Clinic and Manuel Medical Clinic.  Marieva Briceno contributed capital to fund the opening of one clinic, and assisted her daughter, Hernandez, in the daily management of the clinics.  At each clinic, Hernandez and Marieva Briceno hired recruiters, who paid cash bribes to Medicare beneficiaries to attend the clinics and provide their Medicare numbers and other information.  Hernandez and Marieva Briceno admitted that they used the beneficiary information to bill for medically unnecessary diagnostic tests and treatments.  Henry Briceno admitted that he incorporated Manuel Medical Clinic and opened a bank account to conceal the actual ownership of the clinic.  According to court documents, Blessed Medical Clinic, Alpha & Omega Medical Clinic and Manuel Medical Clinic fraudulently billed Medicare for $5.4 million during the course of the scheme.

Today’s guilty pleas were announced by Assistant Attorney General Lanny A. Breuer of the Justice Department’s Criminal Division; U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade; Special Agent in Charge Andrew G. Arena of the FBI’s Detroit Field Office; and Special Agent in Charge Lamont Pugh III of the HHS Office of Inspector General’s (OIG) Chicago Regional Office.
   
This case is being prosecuted by Assistant U.S. Attorneys Frances Lee Carlson and Philip A. Ross of the Eastern District of Michigan, with assistance from Assistant Chief Gejaa T. Gobena of the Criminal Division’s Fraud Section.  The case was investigated by the FBI and HHS-OIG, and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan.    

Since their inception in March 2007, the Medicare Fraud Strike Force operations in nine districts have charged more than 1,190 individuals, who collectively have falsely billed the Medicare program for more than $3.6 billion.  In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.