Dr. Roberto A. Fernandez was sentenced to 97 months in prison for prescribing medically-unnecessary drugs to patients in exchange for financial kickbacks. In addition to his prison sentence, Fernandez was ordered to pay $4.8 million in restitution after he plead guilty to wire fraud and conspiracy to commit healthcare fraud.
Fernandez referred patients to pharmacies to obtain medications they didn’t need. In some cases, the prescribed drugs were contraindicated with other drugs the patients were already taking. As a thank you for the uptick in referrals, pharmacy owners rewarded Fernandez with kickbacks in the form of extra pain pills and fraudulent Medicare billing for services that never took place. Fernandez amassed an extensive network of co-conspirators; the fraudulent billing and pain pill scheme involved six health care facilities and racked up more than $20 million in false expenses.
According to the Department of Justice, Fernandez received kickbacks for “signing plans of care and prescriptions for medically unnecessary home health services.” The dishonest doctor also admitted to providing “prescriptions for expensive, name brand drugs, including HIV/AIDS medications that conflicted with other HIV drugs already prescribed to the beneficiaries.” Several of the pharmacy owners and healthcare professionals involved in the scheme with Fernandez are already behind bars. A MA criminal defense attorney can help you determine how to proceed if you’ve been charged with a crime.
Six Years of Fraud and Distribution
In addition to wire and health care fraud, Dr. Fernandez was charged with:
- conspiracy to defraud the U.S. government by paying and receiving healthcare bribes and kickbacks.
- conspiracy to distribute controlled substances.
- distribution of controlled substances.
According to law enforcement, the fraudulent Medicare claims and illegal prescription of controlled substances, including opioids, had been going on for at least six years.
Fernandez is Not Alone
This latest health care scheme comes on the heels of a $1.3 billion national health care fraud crackdown, which involved 412 defendants, including 115 physicians, nurses and other licensed health care professionals. Those charged were involved in the illegal prescription and distribution of opioids and other narcotics. Attorney General Jeff Sessions announced the largest-ever health care fraud takedown in July.
“Too many trusted medical professionals like doctors, nurses, and pharmacists have chosen to violate their oaths and put greed ahead of their patients,” said Sessions. “Amazingly, some have made their practices into multimillion dollar criminal enterprises. They seem oblivious to the disastrous consequences of their greed. Their actions not only enrich themselves often at the expense of taxpayers but also feed addictions and cause addictions to start. The consequences are real: emergency rooms, jail cells, futures lost, and graveyards. While today is a historic day, the Department’s work is not finished. In fact, it is just beginning. We will continue to find, arrest, prosecute, convict, and incarcerate fraudsters and drug dealers wherever they are.”
Penalties for Health Care Fraud
A conviction of federal health care fraud is a serious offense that may result in the following penalties:
- Up to 10 years in prison for each offense
- Up to 20 years in prison if the fraud resulted in serious bodily injury
- Up to life in prison if the fraud resulted in death
- Up to $250,000 per offense for false Medicare or Medicaid claims, up to billions for organizations that engage in multiple counts of health care fraud
- Restitution to pay back money that was illegally obtained