ELLICOTT CITY DOCTOR SENTENCED IN MEDICAID FRAUD CASE
Baltimore - J. Joseph Curran, Jr., announced today that a Howard County Pediatrician, Alfredo J. Herrera, M.D., was sentenced to three years incarceration with all but 18 months suspended, for billing the Medicaid Program for providing $100,000 worth of services to his patients that were not medically necessary. Howard County Circuit Court Judge Diane Leasure ordered Dr. Herrera to serve the 18-month sentence in the form of home detention.
Herrera, 53, of the 2900 block of Poland Springs Dr., Ellicott City, pleaded guilty to one count of Medicaid Fraud on March 6, 2001, admitting to performing a combination of unnecessary tests on his patients. Dr. Herrera also billed Medicaid for more expensive levels of office visits than had actually occurred.
Dr. Herrera performed tests for strep throat on children who were not sick and billed Medicaid for performing these tests. One child visited Dr. Herrera complaining of a patch of dry skin on his right cheek. Dr. Herrera performed and billed the Medicaid program for a rapid strep test, throat culture, and a test that measures the amount of fluid behind the ear.
Judge Leasure ordered Herrera to serve three years probation at the completion of his 18-month sentence. Dr. Herrera must also pay $200,000 in restitution to the Department of Health and Mental Hygiene. The restitution is twice the amount of the fraud and must be paid within six months of the date of his sentence. Dr. Herrera must also perform 600 hours community service, providing free medical care to uninsured children.
"Such blatant fleecing of the Medicaid Program will not be tolerated," Attorney General Curran said. "This program exists to help people who depend on Medicaid to pay for the high costs of medical treatment, not to line the pockets of greedy doctors."
The Attorney Generalís Medicaid Fraud Control Unit previously charged Dr. Herrera in Anne Arundel County last fall with lying on his 1996, 1997 and 1998 tax returns by claiming personal expenses as business expenses. Dr. Herrera claimed home improvements such as a sun porch, hot tub, pool table, and landscaping as business expenses. He also claimed that a 1998 trip to France to see the World Cup Soccer Final with his son was a business expense. Under the terms of the Plea Agreement, the State dismissed three counts of tax perjury against Herrera, who is required to file amended tax returns for 1996 through 1998, and to pay any interest and penalties that are due.
The Department of Health and Mental Hygieneís Surveillance and Utilization Review Subsystem discovered and referred this case to the Attorney Generalís Medicaid Fraud Control Unit, who investigated and prosecuted the case.