Miami Clinic Owner and Patient Recruiters Plead Guilty in $5.8 Million Medicare Fraud Scheme

April 23, 2010 - Maria Volero Marrero, 48, Lawrence Edward Humes, 57, and Keith Earnest Humes, 53, each pleaded guilty to conspiracy to commit health care fraud in connection with a $5.8 million Medicare fraud scheme stemming from their involvement with a Miami-area HIV/AIDS infusion clinic, announced the Departments of Justice and Health and Human Services (HHS) today.

Keith Humes pleaded guilty yesterday and Marrero and Lawrence Humes pleaded guilty April 21, 2010, before U.S. District Judge Ursula Ungaro in the Southern District of Florida.

In connection with her plea, Marrero admitted that she owned and operated Tendercare Medical Center Inc., a purported HIV/AIDS infusion clinic. Marrero admitted that she conspired with Lawrence Humes, Keith Humes and others to defraud Medicare by submitting claims for services that were medically unnecessary and that in most instances were not provided. Marrero also admitted that she paid kickbacks to Lawrence Humes and Keith Humes and to other recruiters to induce Medicare beneficiaries to provide their Medicare numbers and signatures. The beneficiaries’ numbers and signatures were used by Tendercare to submit claims to Medicare for medically unnecessary injection and infusion services.

In connection with their pleas, Lawrence Humes and Keith Humes admitted that they conspired with Marrero, and that they paid kickbacks to Medicare beneficiaries to induce the beneficiaries to participate in the scheme. Lawrence Humes and Keith Humes admitted that they were aware that the injection and infusion treatments were medically unnecessary and were not being provided.

According to court documents, between January 2005 and December 2007, Tendercare submitted approximately $5.8 million in false and fraudulent claims to Medicare for medically unnecessary injection and infusion treatments. Medicare paid Tendercare approximately $2.7 million as a result of those fraudulent claims.

Sentencing for Marrero, Lawrence Humes and Keith Humes is scheduled for July 23, 2010, before U.S. District Judge Ursula Ungaro Jr. in Miami.

Today’s guilty pleas were announced by Assistant Attorney General Lanny A. Breuer of the Criminal Division, U.S. Attorney Jeffrey H. Sloman of the Southern District of Florida and HHS Office of Inspector General.

The case was prosecuted by Section Assistant Chief John S. (Jay) Darden and Special Trial Attorney Martha Talley of the Criminal Division’s Fraud Section. The case was investigated by the FBI.

The case was brought as part of the Medicare Fraud Strike Force, supervised by the U.S. Attorney’s Office for the Southern District of Florida and the Criminal Division’s Fraud Section. Since their inception in March 2007, Strike Force operations in seven districts have obtained indictments of more than 550 individuals who collectively have falsely billed the Medicare program for more than $1.1 billion. In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.