The former operator of several HIV/AIDS clinics in New York City was sentenced to 63 months in federal prison for his role in a $12 million Medicare Fraud scheme. George Juvier previously pleaded guilty to one count of felony conspiracy to commit healthcare fraud and was sentenced last week. In addition to the over five years in prison he must also pay restitution of $12.3 million.
According to court records, Juvier and several other set up healthcare clinics in Queens, Brooklyn and the Bronx to treat patients suffering from HIV and AIDS. Juvier told Medicare that the clinics were providing valuable injection and infusion treatment to patients. In actuality, the clinics were a massive Medicare fraud scheme. Prosecutors said that either the treatments were not provided or provided with highly diluted doses. Often the patients receiving “treatment” did not need therapy.
Patient Recruiters and Medicare Fraud
Like many urban Medicare fraud schemes, Juvier used “patient recruiters” to lure people to his clinics. The recruiters were paid a bounty to find Medicare eligible HIV positive patients and sign them up for treatment. Patient recruiters often troll homeless shelters, soup kitchens and the streets looking for prospective patients.
Once recruited, the patients were given expensive drugs typically used for cancer patients. It didn’t appear to matter whether or not the patients needed the treatments. In many instances, Medicare was billed for the infusions even though none were given.
Because Juvier was raking in so much money, he was able to pay kickbacks to both the patients and recruiters. Often the bounty was as high as $300. Payments were also made to patients who referred new patients. Everyone was making money. Except taxpayers, of course.
Juvier wasn’t a doctor and so he couldn’t prescribe the expensive drugs. But he did coach patients on how to lie and what to say to insure they passed medical review. The scheme ultimately ripped off Medicare for over $12 million. Because the Medicare system is supported by tax dollars, taxpayers were left holding the bag.
At his sentencing last week, prosecutors sought a sentence of between 63 and 78 months. Oscar Huachillo, Juvier’s co-conspirator, was previously sentenced to 87 months for being the mastermind of the scheme.
The Justice Department says the scheme was hatched in 2009 by Huachillo and two others, one of whom is a physician. Although not named in the indictment, the government says the doctor had “involvement with prior fraudulent health care clinics.” Huachillo got the scheme rolling and appears to be the one responsible for setting up the clinics. Juvier was a big player too, however. He helped recruit doctors to screen patients and prescribe expensive therapies. Later he opened his own clinics.
Ultimately, the government said Huachillo bilked the government for $31 million while Juvier’s clinics were responsible for $12 million in fraud. Even though Juvier’s crimes were smaller in terms of dollars, Juvier is no stranger to the criminal justice system. Prosecutors told the court that Juvier had eight prior convictions related to an illegal lottery scheme and a 2002 conviction for engaging in a “no fault” insurance scam based on a staged car accident and false billing to a private insurance company.
Juvier’s lawyer had argued for a sentence of no more than 36 months despite the fact that the federal Sentencing Guidelines called for a much longer sentence. In arguing for a lower sentence, his lawyer suggested in a bizarre argument that Juvier should receive leniency because he had paid taxes on his ill-gotten gains. He also suggested that the Sentencing Guidelines in white collar crimes could be considered a “black stain on common sense.”
The court disregarded Juvier’s leniency pleas and gave him 63 months.
After the sentencing, Manhattan U.S. Attorney Preet Bharara said, “Jorge Juvier and his co-conspirators set up and operated health care fraud mills and billed Medicare for HIV/AIDS medications that were incorrectly provided or not provided at all. Juvier and his co-conspirators effectively stole more than $12 million from U.S. taxpayers that could have been used to pay for legitimate Medicare expenses.”
Medicare Fraud and Whistleblower Awards
Medicare fraud has reached epidemic levels in the United States. It not only costs taxpayers their hard earned money, it also depletes funds to help those people truly in need of healthcare.
Most Medicare fraud cases come to light because of whistleblowers, men and women with inside information of healthcare fraud. Under the federal False Claims Act, whistleblowers who file claims can receive between 15% and 30% of what the government recovers from the wrongdoer.
Unless you were a major player in the scheme, we can usually help you file a whistleblower complaint, collect an award and keep you out of trouble. Generally the government isn’t interested in criminally prosecuting the minor players. Before you call a Medicare fraud hotline, however, call us first.
If you know of clinics paying kickbacks, employing patient recruiters, diluting medications, billing for services not performed or billing for medically unnecessary services, contact us immediately. Whistleblower awards are often on a first come basis… Don’t delay!
MahanyLaw – America’s Medicare Fraud Lawyers