Miami Doctor in Prison for Medicare Fraud

A Miami-area doctor was sentenced to 41 months in prison for her role in schemes to defraud the Medicare program, Acting Assistant Attorney General Matthew Friedrich of the Criminal Division and U.S. Attorney R. Alexander Acosta of the Southern District of Florida announced today.

In addition to the prison term, U.S. District Court Judge Cecilia M. Altonaga sentenced Ana Caos, M.D., 62, to three years of supervised release following her release from prison and ordered her to pay $294,614 in restitution. Caos was remanded into federal custody at the conclusion of the sentencing. After a nine-day trial in Miami, a federal jury found Caos guilty on April 30, 2008, on all charged counts, including conspiracy to defraud the U.S. government, to cause the submission of false claims to Medicare, and to solicit and receive kickbacks; and conspiracy to commit health care fraud.

At trial, the jury heard testimony that Caos wrote prescriptions for medications and durable medical equipment (DME) that Medicare beneficiaries did not want or need, for the purpose of billing Medicare. The jury heard testimony that Caos falsely diagnosed beneficiaries with chronic obstructive pulmonary disease (COPD) and prescribed unnecessary aerosol medications, including compounded medications delivered by Miami pharmacies. Compounding refers to the process of a pharmacist mixing the medication in the pharmacy, instead of purchasing it from a pharmaceutical manufacturer. At trial, expert testimony revealed that prescribing compounded aerosols as treatment for COPD is unnecessary because commercially available medications can be used to treat the disease. Medicare beneficiaries testified that they were paid every month to accept delivery of the unnecessary medication, as well as the DME. Both the medication and the equipment were paid for by Medicare. At trial, one Medicare beneficiary testified that she threw her medication in the trash upon receipt.