Ms. Martinez previously pleaded guilty to conspiracy to commit healthcare fraud. According to information contained in plea documents, Ms. Martinez admitted that in approximately March 2006, she devised a scheme with co-conspirator Jose Rosario to open a clinic that purported to specialize in infusion and injection therapy services in Michigan, when in fact, the sole purpose of the clinic was to defraud Medicare. Ms. Martinez and her co-conspirators opened Sacred Hope Medical Center in Southfield, Mich., in Oct. 2006. Ms. Martinez was an owner of the clinic, and she also managed the clinic on a day-to-day basis. Ms. Martinez and Mr. Rosario recruited various co-conspirators into their scheme, including an office manager, Lill Vargas-Arias, to help run the clinic; a physician, purportedly to treat patients at the clinic; and recruiters, who were in charge of bringing Medicare beneficiaries to the clinic.
Ms. Martinez admitted that during the time Sacred Hope was open, the clinic routinely billed the Medicare program for services that were medically unnecessary or were never provided. Ms. Martinez admitted she was aware that the clinic had purchased only a small fraction of the medications that the clinic billed the Medicare program for providing. She also admitted that patients were prescribed medications at the clinic based not on medical need, but on what medications were likely to generate Medicare reimbursements. Ms. Martinez, along with Mr. Rosario, admitted to helping falsify medical files maintained by the clinic to make the treatments purportedly being given there appear legitimate, when in fact they were not.
Ms. Martinez also admitted that Medicare beneficiaries were not referred to Sacred Hope by their primary care physicians, or for any other legitimate medical purpose, but rather were recruited through the payment of kickbacks. In exchange for those kickbacks, Ms. Martinez admitted, the Medicare beneficiaries would visit the clinic and sign documents indicating that they had received the services billed to Medicare. Kickbacks came in the form of cash and prescriptions for narcotic drugs.
Ms. Martinez also admitted that beginning in approximately Nov. 2006, she and other co-conspirators opened another, almost identical, infusion and injection clinic called Xpress Center in Livonia, Mich. As with Sacred Hope, XPC’s sole purpose was to defraud Medicare. Ms. Martinez and her co-conspirators used the same fraudulent practices to open and then operate XPC as they did with Sacred Hope, including creating fictitious patient files to cover up fraudulent billings to Medicare.
Ms. Martinez also admitted that her actions at Sacred Hope and XPC were not her first with Detroit-area clinics that purported to specialize in infusion and injection therapy. In particular, she admitted that in approximately March 2006, she became involved in a scheme to recruit Medicare beneficiaries to come to Dearborn (Mich.) Medical Rehab Center, clinic that operated similar to Sacred Hope and XPC.
Ms. Martinez and her co-conspirators caused the submission of approximately $15.31 million in false and fraudulent claims to the Medicare program for services purportedly provided at Sacred Hope, XPC and DMRC. Medicare paid more than $10.7 million on those claims.
Read the DOJ’s release on Daisy Martinez.
