Medical Biller Sentenced to 10 Years Imprisonment for Medicare Fraud

R. Alexander Acosta, United States Attorney for the Southern District of Florida, and Jonathan I. Solomon, Special Agent in Charge, Federal Bureau of Investigation, Miami Field Office, today announced that defendant Diana Sotto, an owner of All Medical Billing Solutions, Inc. ( All Medical Billing ), a medical billing company, was sentenced on January 31, 2007 by United States District Court Judge Cecilia M. Altonaga to 121 months’ imprisonment ( 10 yrs. ), followed by 3 years of supervised release. Judge Altonaga also set a hearing to determine the amount of restitution to be ordered in the case.

On October 2, 2006, Sotto was convicted by a Miami jury on three ( 3 ) counts of a Superseding Indictment that charged her with conspiracies to defraud Medicare, pay health care kickbacks, and launder health care fraud proceeds.

According to the evidence at trial, a Miami medical clinic, Project New Hope, defrauded Medicare of more than $2.8 million between September 2004 and September 2005. The clinic claimed to specialize in the treatment of HIV patients. The patients who attended the clinics were, in fact, HIV positive. The clinic fraudulently billed Medicare for dosages of expensive HIV medications, including Neupogen, Procrit, Acthar, and Fuzeon. The evidence at trial showed that most patients did not receive the medication for which Medicare was billed. In addition, the evidence showed that clinic personnel paid kickbacks to Medicare beneficiaries to induce them to attend the clinic.

The evidence at trial also showed that Sotto’s company, All Medical Billing, submitted the fraudulent Project New Hope claims to Medicare and that Sotto received more than $600,000 in fraud proceeds, the majority of which she laundered through five shell corporations.

Five of Sotto’s co-defendants pleaded guilty before trial to various charges in the same case. These defendants were Luis Manuel Fernandez, Maria Loriga, Beatriz Fernandez, Manuel Ivan Perez, and Walter Lefurge. A sixth co-defendant, Sandra Galvez, was convicted by the same jury that convicted Sotto.

Judge Altonaga previously sentenced Luis Manuel Fernandez to 78 months’ imprisonment; Maria Loriga to 46 months’ imprisonment; Beatriz Fernandez to 18 months’ imprisonment; Manuel Ivan Perez to 35 months’ imprisonment; Walter Lefurge to 3 years’ probation; and Sandra Galvez to 73 months’ imprisonment.

Mr. Acosta commended the investigative efforts of the Federal Bureau of Investigation in the cases involving purported HIV infusion clinics in the Southern District of Florida. The case was prosecuted by Assistant United States Attorneys Marc Osborne and Jeffrey Marcus.