Alvarez-Jacinto's punishment was upheld last year in an Atlanta-based federal appellate court ruling written by retired U.S. Supreme Court Justice Sandra Day O'Connor. Sitting as a guest panelist, she declared that "a doctor should be punished more severely than other participants because the doctor is breaching a position of trust and an ethical obligation to put the patient's interest first."
Lenard echoed that belief repeatedly Monday as she slammed de los Rios for falsifying hundreds of patient records to justify writing bogus prescriptions for two Miami-Dade clinics — Metro Med of Hialeah and J&F Community Medical Center — that billed Medicare a total of $46.2 million for HIV therapy between 2003 and 2005.
In turn, Medicare paid the clinics $19.7 million for HIV treatments that were either unnecessary or not provided to patients, many of whom received kickbacks for use of their government-issued health care cards.
"It is the medical doctor who holds the position of trust," the judge said. "It was violated by the medical director of Metro Med and J&F."
She reminded de los Rios that while he is 72, he was 64 when he joined the racket headed by Metro Med's owner, Damaris Oliva, who pleaded guilty, cooperated with authorities and was sentenced to about seven years.
According to prosecutors, Oliva learned the Medicare fraud business from brothers Carlos, Luis and Jose Benitez, who owned 11 HIV clinics in Miami-Dade that billed the federal program $119 million and were paid $84 million. They fled to the Dominican Republic and then to Cuba before their indictment was unsealed in 2008. They are believed to be incarcerated in a Cuban jail on immigration violations, according to the FBI.