Infusion Therapy Fraud Leads To Prison For Doctor And Clinic Owner

An owner and a physician associated with a Detroit-area infusion therapy clinic were sentenced to 120 months and 97 months in prison, respectively, for their roles in a $2.3 million Medicare fraud scheme. 

Juan De Oleo, an owner of Xpress Center Inc. (XPC), and Dr. Rosa Genao, a physician associated with XPC were sentenced by U.S. District Court Judge Denise Page Hood in the Eastern District of Michigan.   In addition to their prison terms, De Oleo and Genao were sentenced to three years of supervised release and were ordered to pay jointly and severally $1.7 million in restitution.  
 
De Oleo and Genao were convicted after a seven day trial in August 2010.   De Oleo was convicted of one count of conspiracy to commit health care fraud, five counts of health care fraud and two counts of money laundering.   Genao was convicted of one count of conspiracy to commit health care fraud, five counts of health care fraud and one count of destruction or alteration of records.
 
According to evidence presented at trial:
 
De Oleo and others established XPC for the sole purpose of defrauding Medicare.   XPC was an outpatient clinic that purported to specialize in infusion and injection therapy. De Oleo and his co-conspirators imported the concept of infusion clinic fraud to Detroit from South Florida after increased law enforcement scrutiny there.  
 
De Oleo enlisted his wife, Genao, to help falsify medical files at XPC to make it appear that the clinic’s patients actually needed the medications being billed to Medicare. She wrote down fictitious symptoms in the patient charts maintained by the clinic to justify expensive and exotic medications that the clinic billed to Medicare.
 
XPC purchased only a small fraction of the medications that the clinic billed the Medicare program for providing.   Patients were prescribed medications at the clinic based not on medical need, but rather on what medications were likely to generate the highest Medicare reimbursements.
 
Medicare beneficiaries were not referred to XPC by their primary care physicians, or for any other legitimate medical purpose, but rather were recruited to come to the clinic through the payment of cash kickbacks.   In exchange for those kickbacks, the Medicare beneficiaries would visit the clinic and sign documents indicating that they had received the services billed to Medicare.  
 
Between approximately November 2006 and March 2007, the defendants submitted approximately $2.3 million in claims to Medicare for injection therapy services that were never provided and were not medically necessary.   Medicare paid approximately $1.7 million of those claims.