U.S. Department of Justice Marcos Daniel Jiménez United States Attorney for the Southern District of Florida
	99 N.E. 4th Street Miami, FL 33132 (305) 961-9001

20 PEOPLE INDICTED IN $5 MILLION DOLLAR HEALTH CARE FRAUD SCHEME

Marcos Daniel Jiménez, United States Attorney for the Southern District of Florida; Michael S. Clemens, Acting Special Agent in Charge of the Federal Bureau of Investigation (FBI); Linda S. Little, Special Agent in Charge of the Department of Health and Human Services, Office of Inspector General; and James K. Belz, Postal Inspector in Charge, United States Postal Inspection Service, Miami Division, announced today the unsealing of a 26-count Indictment, charging 20 people, including 3 doctors, in a multi-million health care fraud scheme. All 20 defendants are charged with conspiracy to commit health care fraud, in violation of Title 18, United States Code, Section 371; 3 defendants are charged with a witness tampering conspiracy in violation of Title 18, United States Code, Section 371; 4 defendants are charged with a conspiracy to commit money laundering, in violation of Title 18, United States Code, Section 1956(h); 2 defendants are charged with witness tampering, in violation of Title 18, United States Code, Section 1512(b); and 3 defendants are charged with paying illegal healthcare kickbacks, in violation of Title 42, United States Code, Section 1320a-7b(b)(2).

The health care fraud conspiracy and witness tampering conspiracy both carry a maximum statutory penalty of 5 years’ imprisonment, the money laundering conspiracy carries a maximum statutory penalty of 20 years’ imprisonment, and the kickback charges carry a maximum statutory penalty of 5 years’ imprisonment.

The Indictment charges that from 1997 to 2002, Heldy Artiles and her husband, Orlando Artiles, Jr., conspired with physicians, a physician’s assistant, physical therapists, and others to fraudulently bill Medicare and private insurance companies for approximately $5.5 million of medical services, medical equipment, medications, and physical therapy that was either not provided or was medically unnecessary. Also charged in the Indictment are Elva Monteagudo, Heldy Artiles’ mother; Jose Garrido, Edgar Zamora, and Guillermo Garcia, medical doctors; Alberto Exposito, a physician’s assistant; Noelia Davila and Dulce Suarez, physical therapists; Dafne Mesa; Dalia Fernandez; Elayne Sanchez; Carmen Arelis Pichardo; Margarita Campos; James Lyons; Candelaria Alvarez; Olga Gonzalez; Antonio PiZa; Deisy Aviles; and Tomas Del Coral.

As set forth in the Indictment, the scheme involved Miami Health Medical Center (Miami Health), a Miami medical clinic; Exclusive Medical Supply, Inc., and Hope Medical Supplies, Inc., Miami durable medical equipment companies; and Ideal Pharmacy, a Miami pharmacy. According to the Indictment, Medicare has stopped making payments to all four companies.

The Indictment charges that the Artileses and their co-conspirators paid kickbacks to patients to serve as patients of Miami Health and the other three medical companies. The Indictment also charges that the conspirators coached patients to fake medical problems during the visits to Miami Health.

On other occasions, according to the Indictment, the conspirators staged automobile accidents, paying bribes to the supposed victims to get them to complain of non-existent injuries when they went to Miami Health. Based on the falsified injuries, Miami Health then submitted fraudulent claims to automobile insurance companies to be paid for the cost of medically unnecessary physical therapy, which was allegedly performed at the medical clinic.

In connection with the health care fraud scheme, the Indictment charges that Heldy Artiles and several co-defendants falsified doctors’ notes and patient medical records, adding false patient complaints, fabricating doctors’ diagnoses and treatment plans, and ordering unnecessary tests, medications, equipment, and physical therapy.

According to the Indictment, doctors Garcia, Zamora, and Garrido, who worked at various times at Miami Health, signed and approved altered medical records and fraudulent prescriptions, knowing, in some instances, that the underlying patient office visits had never occurred and otherwise knowing that unnecessary medical services, medications, equipment, and physical therapy were being ordered.

The Indictment also charges the Artileses and Lyons with witness tampering. Orlando Artiles allegedly paid patients to sign affidavits falsely stating that the patients had never been paid bribes by Artiles. The Indictment states that the Artileses destroyed and altered documents subpoenaed by the government. Heldy Artiles allegedly directed a Miami Health employee to lie to a federal grand jury about other subpoenaed documents.

The Indictment also charges the Artileses, Monteagudo, and Fernandez with conspiring to launder the proceeds of the health care fraud scheme. The Indictment seeks the forfeiture of $1.6 million of currency, a 2003 Chevrolet Silverado, and at least 5 Miami-Dade County real properties.

In September 2003, the United States Attorney’s Office filed a civil suit against the Artileses, Monteagudo, Garcia, and Lucia Sanchez, an associate of the Artileses, seeking to freeze proceeds of the health care fraud. United States District Judge Adalberto Jordan subsequently granted the government’s request for an injunction to temporarily freeze various assets, including Artiles real estate.

Mr. Jiménez commended the investigative efforts of the Federal Bureau of Investigation, the United States Department of Health and Human Services, Office of Inspector General, the United States Postal Inspection Service, and the National Insurance Crime Bureau, of Plantation, Florida. The criminal case is being prosecuted by Assistant United States Attorney Joan Silverstein. The civil injunctive lawsuit is being handled by Assistant United States Attorney Mark A. Lavine.

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