Roger Rousseau, Doris Crabtree, Angela Salafia, Liliana Marks, Ruben Busquets, Alina Fonts, and Blanca Ruiz, all Miami-Dade County, Florida health care professionals, were arrested Tuesday after they were accused of participating in a scheme to defraud Medicare out of millions of dollars, a press release from the U.S. Attorney for the Southern District of Florida indicates. Rousseau, 71; Crabtree, 61; Salafia, 65; Marks, 46; Busquets, 49; Fonts, 47; and 59-year-old Ruiz all face charges of conspiring to commit health care fraud. Fonts faces two additional counts of health care fraud, while Crabtree, Salafia, Marks and Busquets face two additional counts of making false statements related to health care matters. Rousseau has since been released after posting a $375,000 bail bond amount. The other defenendants also qualified for bail bond. It is unclear whether all of the defendants have obtained lawyers.
According to reports, Rousseau, a medical doctor, and the defendants, all therapists, once worked for Armando “Manny” Gonzalez, who owned and operated Health Care Solutions Network in Florida. Based on reports, Gonzalez was once convicted of trafficking cocaine and opened two mental-health clinics, one in Cutler Bay and the other in Kendall, in the early 2000s. He allegedly opened these clinics as a way to defraud Medicare. Several years later, he relocated to North Carolina, where he opened an additional clinic. Gonzalez was later apprehended on charges of Medicare fraud that had occurred within his businesses. In February, Gonzalez was sentenced to 14 years in prison after he pled guilty to those charges.
Based on reports, Rousseau worked as a medical director at Health Care Solutions Network. Crabtree, Salafia, Marks, Busquets, Fonts, and Ruiz served as therapists at the clinics. At that clinic, Rousseau “routinely signed what he knew to be fabricated and altered medical records without ever reviewing the materials, and, in most instances, without ever meeting with the patient,” the federal indictment says.
In addition, the indictment claims Crabtree, Salafia, Marks, Busquets, Fonts and Ruiz “fabricated HCSN medical records to support false and fraudulent claims for partial hospitalization program services that were not medically necessary and were not provided.” Many of the patients who did receive therapy at the clinic allegedly suffered from diseases such as Alzheimer’s and dementia, ailments that do not respond well to therapy. In all, reports say the illegal operation started by Gonzalez netted $63 million in fraudulent funds from the taxpayer-funded Medicare program. Of that money, the indictment claims “HCSN allegedly received payments totaling approximately $28 million.”
According to the indictment, “The case is being investigated by the FBI and HHS-OIG, and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida.”
The Medicare Fraud Strike Force was created in March 2007 to uncover instances of Medicare fraud. Since its inception, the strike force has begun operations across nine cities throughout the United States. To date, the program has charges over 1,500 defendants who allegedly billed the Medicare program an excess of $5 billion, federal sources indicate.