HIV clinic operator pleads guilty to $23M Medicare fraud

The owner of a South Florida clinic pled guilty on Sept. 9 to fraudulently billing the Medicare program for $23 million of HIV-related treatments.

Flor Crisologo entered a guilty plea to one count of conspiracy to commit healthcare fraud in federal court in Miami last week, four months after being indicted, reports Healthcare Finance News.

The 58-year-old Crisologo had submitted false claims through the clinic she operated just north of Miami, J&F Community Medical Center, according to the U.S. Justice Department. She was originally charged with 10 counts of submitting false claims to Medicare, payment of kickbacks and conspiracy to commit money laundering.

Crisologo worked with a physician she had hired to order medically unnecessary tests and procedures for Medicare patients, specifically injections and infusion therapies for those who test HIV-positive, according to law enforcement officials. Those patients in turn were offered kickbacks to claim they had undergone testing when they had not, or that the tests were medically necessary for their health, said the DOJ.

Although the investigation and arrest of Crisologo were conducted by the Federal Bureau of Investigation and the Health and Human Services' Office of the Inspector General, she was targeted by the Health Care Fraud Prevention and Action Task Force, a joint venture between HHS and the U.S. Justice Department to combat healthcare fraud.

Crisologo faces up to 10 years in prison on the single charge, as well as forfeiture of assets. She faces sentencing on Nov. 23.

For more:
- read the DOJ press release
- read the Healthcare Finance News article