U.S. v. Alina De Armas

* 

Case 1:12-cr-20282-WJZ Document 2 Entered on FLSD Docket 04/25/2012 Page 1 of 10 

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UNITED STATES OF AM ERICA 

V*. 

ALINA DE ARM AS, 

Defendant. 

UNITED STATES DISTRICT COURT 

CASE 

SOUTHERN 

NO. 

DIS %OF 

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FL RIDA 

18 U.S.C. j 1347 

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42 U .S.C. j 1320a-7b(b)(2)(A, jv . j.>l, k .a , ,r y. yjt , ,., rw j' $ +. ' A. .'b-' , y x 

18 U.S.C. j 2 

18 U.S.C. j 982 

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INFORM ATION 

The United States Attorney charges that: 

GENERAL ALLEGATIONS 

At all times material to this Information: 

The M edicare Prozram 

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SOSENBAUM 

1. The Medicare Program (çlMedicare') was a federaly funded progrnm that provided 

free or below-cost health care benefits to certain individuals , primmily the elderly, blind, and 

disabled. The benefits available tmder Medicare were governed by federal statutes and regulations . 

The United States Department of Health and Human Services , through its agency, the Centers for 

Medicare and Medicaid Services ($çCMS'), oversaw and administered Medicare . Individuals who 

received benefits under Medicare were commonly referred to as Medicare çtbeneficiaries . '' 

2. Medicare programs covering different types of benefits wtre separated into different 

program Stparts.' PM D of Medicare subsidized the costs of prescription dnzgs for Medicare

enetsciaries in the United States. 

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It was enacted as part of the Medicare Prescription Drug , 

Improvement, and Modernization Act of 2003 and went into effect on January 1 , 2006, 

ln order to receive Pal4 D benefits , a beneticiary enrolled in a Medicare drug plan . 

Medicare dnzg plans were operated by private companies approved by Medicare . Those companies 

were ohenreferredto as Medicare drugplan çfsponsors .' A beneticiary in aMedicare drugplan could 

fill a prescription at a pharmacy and use his or her plan to pay for some or a1l of the prescription . 

A pharmacy could participate in PM D by entering a retail network agreement with 

one or more Pharmacy Benefit Managers (tTBMs'). Each PBM acted on behalf of one or more 

Medicare drug plans. When a PM D beneticiary presented a prescription to a pharmacy , the 

phannacy submitted a claim to the PBM that represented the beneficiary's Medicare dl'ug plan . The 

PBM determined whether the phnrmacy was entitled to payment for each claim and periodically paid 

the pharmacy for outstanding claims. The Medicare drug plan sponsor reimbursed the PBM for its 

payments to the pharmacy. 

5. A pharmacy could also submit claims to a Medicare drug plan sponsor to whose 

network the pharmacy did not belong. Submission of such out-of-network claims was not common 

and ohen resulted in smaler payments to the pharmacy by the drug plan sponsor . 

Medicare, through CMS, compensated the Medicare drug plan sponsors . Medicare 

paid the sponsors amonthly fee for each Medicare beneficiary of the sponsors' plans . Such payments 

were caled capitation fees. The capitation fee was adjusted periodicaly based on various factors , 

including the beneficiary's medical conditions . ln addition, in some cases where a sponsor's expenses 

forabeneficiary'sprescription drugs exceededthat benefciary's capitation fee , Medicare reimbursed 

the sponsor for a portion of those additional expenses .

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Medicare and the Medicare drug plan sponsors were 'çhealth care benefit progrâmlsq,' 

as defined by Title 18, United States Code, Section 24(b). 

8. 

M edicare Drug Plan Sponsors 

The Pennsylvania Life lnsurance Company ($çPe1m'), Humana lnsurance Company 

($tHumana'), United Healthcare Insurance Company (çiunited') and Accendo lnsurance Company 

(tdAccendo') were Medicare drug plan sponsors. 

Ultratech Medical Supplies. d/b/a Guines Pharmacy 

Ultratech Medical Supplies was a Florida corporation , incorporated on or about 

January 24, 1991, that did business in Mimni-Dade County purportedly providing prescription drugs 

to Medicare beneficiaries. After on or about July 13 , 1998, Ultratech did business as Guines 

Pharmacy (ç$Guines'). 

The Defendant 

10. ALINA DE ARMAS was a resident of Miami-Dade County and the president and 

registered agent of Guines. 

COUNTS 1-5 

HeaIth Care Fraud 

(18 U.S.C. j 1347) 

Paragraphs 1 through 10 of the General A legations section of this Information are 

realleged and incorporated by reference as though fully forth herein . 

From on or about August 16, 2007, and continuing tkough on or about September 29 , 

201 1, in Miami-Dade County, in the Southern District of Florida , and elsewhere, the defendant, 

ALINA DE ARMAS,


in comwction with the delivery of and payment for health care benefits , items, and services, did 

knowingly and willfully execute , and attempt to execute, a scheme and artifice to defraud health care 

benefit programs affecting commerce, as defined by Title 18 , United States Code, Section 24(b), that 

is, Medicare, Perm, Humana, United, and Accendo , and to obtain, by means of materially false and 

fraudulent pretenses, representations, and promises , money and property owned by, and under the 

custody and control of, said health care benefit progrnms . 

3. 

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Purpose of the Scheme and Artifice 

lt was the purpose of the scheme and artifice for the defendant to unlawfully emich 

herself by, among other things: (a) submiting or causing the submission of false and fraudulent 

claims to health care benefit programs; (b) concealing the submission of false and fraudulent claims 

to health care benefit programs, and the receipt and transfer of fraud proceeds; and (c) diverting fraud 

proceeds for the personal use and benefit of herself and others . 

The Scheme and Artifice 

The manner and means by which ALINA DE ARMAS sought to accomplish the purpose of 

the scheme and artifice to defraud included , among others, the following: 

4. On or about January 16, 2008 ,ALlNA DE ARMAS signed aprovider agreement with 

CVS Caremark Coproration, a PBM, in connection with Guines's operations . 

5. ALINA DE ARMAS submited and caused Guines to submit claims that falsely and 

fraudulentlyrepresented that various health care benefits , primarilyprescription drugs, were medicaly 

necessary, prescribed by a doctor, and had been provided to Medicare beneficiaries . 

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6. As a result of such false and fraudulent claims , Medicare prescription drug plan 

sponsors, including Penn, United, Humana, and Accendo , through their PBMS, made payments to 

Guines in the amount of approximately $3,614,956, which money had been funded by Medicare . 

ALINA DE ARMAS used the proeeeds from the fraudulent claims for htr own 

personal use and benefit and to further the fraud. 

Acts in Execution or Attempted Execution of the Scheme and Artifice 

8. On or about the dates set forth as to each count below , in Miami-Dade County, in the 

Southern District of Florida, and elsewhere , ALINA DE ARMAS, in cormection with the delivery 

of and payment forhealth care benefits , items, and services, did knowingly and wilfuly execute , and 

atempt to execute, the above-described scheme and artifice to defraud health care benefit programs 

affecting commerce, as defined by Title 18 , United States Code, Section 24(b), that is, Medicare and 

Medicare prescription dnzg plan sponsors , and to obtain, by means of materialy false and fraudulent 

pretenses, representations, and promises, money and property owned by , and under the custody and 

control of, said health care benefit programs , in that the defendant submitted and caused the 

submission of false and fraudulent claims seeking the identified dolar nmounts , and representing that 

Guines provided phnrmaceutical items and services to Medicare beneficiaries pursuantto physicians' 

orders and prescriptions:

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Count Medicare Approx. Medicare Claim M edicare Item Claimed; 

Beneficiary Date of Number Drug Plan Approx . Amount 

Submission Sponsor Claimed 

of Claim 

J.A.C. 03/14/201 1 09030751499328262009 Penn Abilify tablets , 30day 

supply; $730.34 

2 E.S.D. 03/14/201 1 1 14730848301 Humana Abilify tablets , 30day 

supply; $704.09 

C.J.A. 03/14/201 1 1 10733278957048998 United Seroquel tablets , 30day 

supply; $619.04 

N.P, 03/14/201 1 30000789457285 Accendo Seroquel tablets , 30day 

supply; $797.28 

B.L.R. 03/14/201 1 30000841870171 Accendo Seroquel tablets , 30day 

supply; $608.36 

ln violation of Title 18, United States Code, Sections 1347 and 2 . 

COUNTS 6-10 

Payment of Kickbaclts in Connection with a Federal Health Care Program 

(42 U.S.C. j 1320a-7b(b)(2)(A)) 

l . Paragraphs 1 through 10 of the General A legations section of this lnformation are re- 

aleged and incorporated by reference as though fully set forth herein . 

2. On or about the dates enumerated below as to each count , in Miami-Dade County, in 

the Southern District of Florida, and elsewhere , the defendant, 

ALINA DE ARM AS, 

did knowingly and willfuly offer and pay any remuneration , that is, kickbacks and bribes, directly and 

indirectly, overtly and covertly, in cash and in kind to a person to induce such person to refer an 

individual forthe furnishing and arranging for the furnishing of any item and service for which payment 

6

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may be made in whole and in part under a federal health care program , that is, Medicare, as set forth 

below: 

Count Approximate Date Approximate Kickback Amount 

6 05/07/2010 $256 

7 08/09/2010 $988 

8 02/18/201 1 $470 

9 03/1 1/201 1 $540 

10 03/22/201 1 $1 ,710 

In violation of Title 42, United States Code , Section 1320a-7b(b)(2)(A) and Title 18, United 

States Code, Section 2. 

FORFEITURE 

(18 U.S.C. j 982) 

1. The alegations contained in this lnformation are reallegedand incorporated by 

reference as though fully set forth herein for the purpose of aleging forfeiture to the United States 

of Ameriea of certain property in which the defendant , ALINA DE ARMAS, has an interest . 

2. Uponconvictionof anyviolationof Title 18 , United States Code, Section 1347 orTitle 

42, United States Code, Section 1320a-7(b), as alleged in Counts 1 through 10 of the Information , the 

defendant shall forfeit all of her right, title and interest to the United States of any property , real or 

personal, that constitutes or is derived , directly or indirectly, from gross proceeds traceable to the 

commission of such violation, pursuant to Title 18 , United States Code, Section 982(a)(7). 

3. The property subjectto forfeiture includes, but is not limited to, the sum of $3,614,956 

in United States currency, which is a sum of money equal in value to the gross proceeds traceable to 

the commission of the violation aleged in this lnformation , which the United States will seek as a 

forfeitlre money judgment as part of the defendant's sentence. 

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Al pursuant to Title 18, United States Codt, Section 982(a)(7); and the procedures set forth 

at Title 2 1, United States Code, Section 853 , as made applicable through Title 18, United States Code , 

Section 982(b)(1). 

8 

t ka ot- 

W IFREDO A. FERRER 

UNITED STATES ATTORNEY 

1c-- 1 ' 

JOHN D. COURIEL 

ASSISTANTUNITED STATES ATTORNEY


! : 

Case 1:12-cr-20282-WJZ Document SOUTHERN 2 Entered DISTRICT on OF FLSD FLORID Docket 04/25/2012 Page 9 of 10 

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UNITED STATES OF AMERICA CASE NO , 7n11*/4765 

VS. 

ALINA DE ARMAS, 

Defendant. 

CERTIFICATE OF TRIAL ATTORNEY (1 

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7 

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(j 

I Superseding Case Information: ) ' 

Court Division: (select one) New Defendants) Yes No 

Number of New Defendants ' 

X 5 - 

. 

Miami FTb wKe 

IB West FTp Total number of counts 

1. probable I have carefuly witnesses considered and the the Iegal alegations 9f the indictm>nt , the number 9f defendants, the number of 

complexlties of the Indlctment/lnformatlon attached hereto. 

( 

2. I am Mware that the information supplied 9n thij jtatement wil be relied upon by the Ju 

d nes 

of this -4 

1t). 

Title Coud 28 In U.S.C. seting theirpalendars Sectlon 3161. and schedulng crlmlnaltrlals underthe mandateof the Spedj 

Trial Act, j( , 

3. Iqterpreter: (Yes Qr No) Mon 

Llst Ianguage and/or dlalect ' l 

4. This case wil take n days for the padies to $ 

try. 

) 

5. Please check appropriate category and Npe of offense listed below: 

2 

(Check only (me) (Check only one) 

l 0 to 5 days 

1 6 to 10 days 

III 11 to 20 days 

IV 21 to 60 days 

V 61 days and over 

X P:ty 

Mlnor 

Mlsdem 

. Felony Y 

6 . Has this case been previously filed in this District Coud? (Yes or No) Nn 

lf 

yes: 

Judge: 

(Atach H copy 9f dispositive Mrdej 

If as a complalnt been filed In thls mater? 

yeq: 

Maglstrate Case No. 

Related Misc:laneous numbers: 

Defendants) ln federal custody as of 

Defendantls) R In state custody as of 

ule 20 from the 

Case No . 

(Yes Or NO) Nn 

District of 

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Is this a potential death penalty case? (Yes or No) Mo i 

7 . Does this case or gi inate from a matter pending in the Northern Region of the U.S. Atorney's Office prior 7 

to October 14, 20'03? 

Yes X No 

8. Does this case originate from a matter pending in the Central Region of th 

to September 1, 2-0077 

Yes Y No e U.S. Attorney's Office prior 

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*penalty Sheetls) atached 

J ohn D Couriel 

( p. - c - j, 

ASSISYANT UNITED STATES ATTORNEY l 

coud No. A5501342 (t !) 

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Defendant's Name: ALINA DE ARMAS 

Case No: 

Counts # 1-5 

Health Care Fraud 

Title 18. United States Code . Section 1347 

* Max. Penalty: 10 years' imprisonment 

Counts #: 6- 10 


SOUTHERN DISTRICT OF FLORIDA 

PENALTY SHEET 

Payment of Kickbacks in Cormection with a Federal Health Care Program 

Title 42. United States Code . Section 1320a-7b(b)(2)(A) 

*Max. Penalty: 5 years' imprisonment

U.S. v. Alina De Armas

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