By Zoey Becker
June 3, 2022
Source: Bitter Winter
Photo Source: Unsplash, Toufiqu Barbhuiya
Florida: the home of the Gators, Disney World, and pharma fraud schemes. At least that's the trend lately.
A month after a Miami court ordered a bank account freeze for people associated with a Gilead Sciences HIV PrEP fraud scheme, the judicial system there has ruled on another multimillion-dollar scheme.
William Clero has received a sentence of 210 months (17.5 years) in prison after pleading guilty to conspiracy to commit mail fraud and wire fraud. Clero earlier this year admitted to being the leader of a $9 million scheme to defraud prescription drug cost-savings programs offered by pharmaceutical manufacturers. His co-defendant, Cesar Armando Perez Amador, received a sentence of 87 months (7.25 years), the feds said.
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Authorities say the scheme started in 2014, when the two men established pharmacies in Miami-Dale County that purportedly provided prescription drugs to people with private health insurance or no health insurance. Clero and Perez then submitted claims to drug savings programs to gain more than $9 million in payments.
The problem? The pharmacies were fake, authorities said.
Clero and Perez set up pharmacies only to submit the fraudulent claims, according to the Department of Justice. None of the pharmacies had real customers or prescriptions, nor did they dispense any medications. Authorities indicted the pair last February on six counts of money laundering, plus conspiracy to commit money laundering offenses. They pled guilty in February.
The National Health Care Anti-Fraud Association estimates that healthcare fraud costs the nation approximately $68 billion annually. It is “nearly impossible” to evaluate every single invoice submitted by healthcare professionals, facilities, and Medicare/Medicaid providers, the group says, opening the door to fraudulent billing across the country.
Common methods of healthcare fraud include coding errors, upcoding, and claiming payment for services not provided.
How can such health care practices impact your health? Life? Why?
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