Unlicensed Florida HIV Clinic Nurse Sentenced in $11 Medicare Fraud Scheme

January 23, 2014 — Health care industry insiders often hold the key to unlocking fraudulent Medicare scams. The government does not have the resources to identify every scheme against government health care programs. That’s where the False Claims Act comes in. The statute includes qui tam language that gives whistleblowers the power to file a lawsuit on the government’s behalf. To reward individuals who have the courage to step forward, the Act entitles tipsters to a substantial cut of the proceeds.

In a Medicare fraud scheme involving conspiratorial family members and runaway fugitives from justice, an unlicensed nurse has been sentenced to 108 months in prison for participating in an $11 million scheme to file false claims for expensive HIV infusion services that were never provided.

Carmen Gonzalez, of Cape Coral, Florida, was captured in 2013 after fleeing the country when she was charged in the scheme in 2008. Gonzales had worked at St. Jude Rehabilitation Center, a fraudulent Miami HIV infusion clinic run by her cousins the Benitez Brothers. Gonzalez was an unlicensed nurse who paid HIV beneficiaries thousands of dollars so that St. Jude could use the beneficiaries’ Medicare information to file millions of dollars in false claims. According to the U.S. Justice Department, Gonzalez fabricated medical records to support the fraudulent Medicare claims and to hide the scheme from detection.

Gonzalez’s father has already been sentenced to prison for his participation in a separate health care fraud scam. The Benitez Brothers remain at large.

Whistleblowers deservedly want to understand their own interests before deciding to file a False Claims Act lawsuit. With experienced qui tam lawyers in Texas and on both coasts, Waters & Kraus is devoted to protecting your rights. When you’re committed to notifying the government, contact us or phone our whistleblower lawyers at 855.784.0268 to learn more about how to file a qui tam lawsuit.