Make us your home page
Instagram

Today’s top headlines delivered to you daily.

(View our Privacy Policy)

Tampa inquiry finds Medicare fraud paid for illegal oxycodone

Brian Francis Kelly admits to a health care fraud conspiracy charge in the federal case in Tampa.

Brian Francis Kelly admits to a health care fraud conspiracy charge in the federal case in Tampa.

TAMPA — A Broward County man with a history of drug dealing found a novel way to front his oxycodone trade.

Medicare Part D.

Brian Francis Kelly, 53, is one of four people accused in a conspiracy to use HIV patients and a Coral Gables clinic to defraud the federal government by filing false claims for drugs and medical care through the now-defunct St. Petersburg Medicare insurer, Universal Health Care Group.

Universal filed for bankruptcy protection last year amid allegations of fraud and embezzlement, but in the latest matter, the government calls the insurer a victim of fraud.

The U.S. Attorney's Office in Tampa unsealed indictments this week against Kelly, Gladys Fuertes, 40, Mario Fuertes, 38, and Cathleen Ortega, 55, based on an investigation by the Tampa Bay office of the Medicare Fraud Strike Force.

In a signed plea agreement, Kelly said he recruited patients for the Fuertes couple's clinic, Gables Medical and Therapy Center, which then used the patient identities to claim reimbursements for medical treatments not provided.

The patients got kickbacks and oxycodone prescriptions, which at times were forged by the Fuerteses, the plea agreement states.

"Some patients took the oxycodone pills prescribed, while others sold the pills to Kelly for cash," the document states. "Kelly sold the oxycodone pills to street-level users and other distributors in Florida and Pennsylvania in exchange for cash, typically between $25 to $50 per pill."

The prescriptions were filled at a Fort Lauderdale pharmacy, which then submitted claims for reimbursement to Universal's Medicare Part D plan.

Medicare Part D is a federal program to subsidize the cost of prescription drugs.

It's unclear how much government money went to oxycodone.

But the Gables clinic filed claims for treatment in excess of $1 million, of which Universal paid $266,423, Kelly's plea agreement states.

In one case, the clinic billed Universal $91,342 for a patient who received no treatment, the document states.

Kelly, originally from Massachusetts, was convicted in Broward in 2006 on charges that included possession with intent to distribute methamphetamine.

In the current federal case, he admits to a health care fraud conspiracy charge, though he has not yet formalized the plea deal with a court appearance.

Ortega, in her plea, admits to making false statements to investigators.

The Fuerteses, arrested Wednesday in Miami, are charged with conspiracy, health care fraud, aggravated identity theft and obstructing a health care investigation.

Patty Ryan can be reached at pryan@tampabay.com or (813) 226-3382.

Tampa inquiry finds Medicare fraud paid for illegal oxycodone 03/28/14 [Last modified: Friday, March 28, 2014 11:24pm]
Photo reprints | Article reprints

© 2017 Tampa Bay Times

    

Join the discussion: Click to view comments, add yours

Loading...
  1. Search for missing Army helicopter crew suspended in Hawaii

    Military

    HONOLULU — Officials have suspended the search for five Army soldiers who were aboard a helicopter that crashed during offshore training in Hawaii last week.

    Water safety officials hand over possible debris from an Army UH-60 Black Hawk helicopter crash to military personnel stationed at a command center in a harbor, Wednesday in Haleiwa, Hawaii, a day after. an Army helicopter with five on board crashed several miles off Oahu's North Shore. Officials  suspended the search for five Army soldiers in a helicopter crash during offshore training in Hawaii on Monday. [Associated Press]
  2. Rubio praises Trump for 'excellent' speech on Afghanistan

    Blogs

    Sen. Marco Rubio praised President Donald Trump's "excellent" speech on Afghanistan. Sen. Bill Nelson was less effusive but agreed with the goal.

  3. Gov. Rick Scott blasts report of shifting words on Charlottesville

    Blogs

    Gov. Rick Scott, one of the most scripted politicians in modern Florida history, said Monday that ‘both sides” bore blame for Charlottesville.

  4. Record $417 million awarded in lawsuit linking baby powder to cancer

    Nation

    LOS ANGELES — A Los Angeles jury on Monday ordered Johnson & Johnson to pay a record $417 million to a hospitalized woman who claimed in a lawsuit that the talc in the company's iconic baby powder causes ovarian cancer when applied regularly for feminine hygiene.

    A bottle of Johnson's baby powder is displayed. On Monday, Aug. 21, 2017, a Los Angeles County Superior Court spokeswoman confirmed that a jury has ordered Johnson & Johnson to pay $417 million in a case to a woman who claimed in a lawsuit that the talc in the company's iconic baby powder causes ovarian cancer when applied regularly for feminine hygiene. [Associated Press]
  5. Search under way for missing sailors; Navy chief orders inquiry

    Military

    SINGAPORE — The U.S. Navy ordered a broad investigation Monday into the performance and readiness of the Pacific-based 7th Fleet after the USS John S. McCain collided with an oil tanker in Southeast Asian waters, leaving 10 U.S. sailors missing and others injured.

    Damage is visible as the USS John S. McCain steers toward Singapore’s naval base on Monday.