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The Miami Herald (FL)
May 7, 1999
Author: ANA ACLE, Herald Staff Writer
The Florida Attorney General’s Medicaid Fraud Control Unit arrested the entire staff of a Little Havana outpatient mental health clinic Thursday – the two owners, the office manager, two counselors and the psychiatrist. Posing as a patient, an undercover agent attended group therapy sessions at Prometeo Counseling Center, 1720 SW Eighth St., and said therapy consisted of drinking Cuban coffee, eating white bread, watching television, listening to music and pleasant “chitchats.”
“Prometeo was paid $1.2 million in Medicaid funds last year for providing what appears to have been little or no meaningful therapy for its clients,” said Bob Butterworth, state attorney general. “The center operated as a sham,” said Steven Kogan, regional chief for the fraud unit.
The undercover agent said that after a 10-minute evaluation, the psychiatrist wanted to hospitalize him. When he declined, the psychiatrist prescribed Prozac .
Counselors said the psychiatrist directed the therapy sessions, but he wasn’t even there, the undercover agent reported. And the sessions, which lasted between 30 minutes to an hour, were billed as four hours. In 1996, the year the clinic opened, it billed the Florida Agency for Health Care Administration an estimated $480,000 for Medicaid. By 1998, the clinic’s billings exceeded $1.2 million. The state froze the clinic’s bank accounts.
Said prosecutor Kogan: “It’s sad because Medicaid provides for the most needy among us and people were not getting the counseling they are entitled to.” After a seven-month investigation, the attorney general reported:
* The clinic gave $50 kickbacks to people willing to enroll as Medicaid eligible mental health clients.
* The clinic billed Medicaid for absent clients. One patient underwent major surgery at a hospital – the same days the clinic billed for a therapy session. Another patient was in jail for the billed days.
The clinic billed for 16 days the agent attended, and for 17 days he didn’t. * The clinic created fictitious psychiatric evaluations and bogus therapy notes.
Among the patients Thursday were Eugenio Rodriguez and Lorenzo Acosta. Rodriguez, 69, arrived on bicycle and found the clinic closed. He is a recovering alcoholic who suffers from depression and anxiety. “They treated us very well,” he said. “The attention was unbeatable.”
He particularly enjoyed the days when vans filled with patients visited the beach, parks, churches or attractions, such as the Miami Seaquarium. The purpose: “to entertain the mind. They’d also give us therapy there,” he said.
Rodriguez said that after he got cut off from food stamps, he ate at the clinic. “I have breakfast and lunch here. I always come here every day around 10 a.m and leave at 1 p.m.”
Acosta, 40, who suffers from depression, has been a patient at the clinic for three years, the same as Rodriguez.”I’m very surprised,” Acosta said. “Every day they’d discuss different topics. The therapist is fantastic.” Kogan said the clinic had no organized activities or schedules of any kind.
The clinic didn’t actually open on Thursday. The state arrested six people at their homes, charging them with multiple counts of engaging in an organized scheme to defraud: co-owner Yolanda Aranzazu, 51, of 11980 SW 112th Ave. Circle; co-owner Lucila Bernal, 58, of 135 Hampton Lane in Key Biscayne; psychiatrist Dr. Francisco J. Borges, 71, of 2430 NW 103rd Ave. in Pembroke Pines; office manager Martha Martinez, 44, of 9310 Fontainebleau Blvd., Apartment 601; counselor Graciela Noble, 56, of 321 NW 109th Ave. Apartment 8; and counselor Fernando Roche, 34, of 2516 SW 20th St.
Aranzazu, Bernal, Martinez, Noble and Roche also face multiple charges of Medicaid fraud. Each charge is a third-degree felony with a maximum penalty of five years in jail and a $10,000 fine.
Borges has a private Little Havana office and is also affiliated with Regional Memorial Hospital in Hollywood. His office said he had no comment. None of the others arrested could be reached for comment.