LOUISVILLE — From Chris Covington's perspective, Rodolfo Bouza sits at the bottom of a large chain of people with one purpose in mind — getting money from the federal Medicare system.
Bouza, a 46-year-old Cuban immigrant from Miami, is wanted in Kentucky on charges that he defrauded the health care plan by submitting bills for medical supplies he never delivered, or, said Covington, a criminal investigator with the U.S. Department of Health and Human Services, had any intention of producing.
The U.S. Department of Health and Human Services Office of the Inspector General is adding Bouza to its most-wanted list. Covington, assistant special agent in charge of the department's investigative arm in Nashville, Tenn., sees catching Bouza as an opportunity to roll up a little more of the web that starts in South Florida and stretches across the country.
"These schemes are fraudulent from the word 'go.' There are no patients, there are no doctors," Covington said. "These people can be hard to catch. As we saw in the case of Mr. Bouza, they disappear."
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Covington said Bouza's case is connected to the prosecutions of four other men in Louisville. Two of those men are awaiting trial, while the other two have pleaded guilty and agreed to repay $1.9 million to the government.
Katherine Harris, a spokeswoman for the Health and Human Services Inspector General's Office, said in the last fiscal year, inspector general investigations have led to the arrest and prosecution of 723 individuals and pulled in more than $4.6 billion to health care programs.
"That's a record year," said Gary Cantrell, assistant inspector general for investigations for Health and Human Services in Washington.
Problems with Medicare fraud have become so pervasive, Cantrell said, that Health and Human Services has set up special teams in Miami; Los Angeles; Detroit; Tampa, Fla.; Houston and Baton Rouge, La.
Interviews with Covington and Cantrell, as well as court records in the case of Bouza and the four other men charged in Kentucky, lay out an alleged scheme starting in Miami with someone hiring recruiters and sprawling across the country, usually ending with someone like Bouza operating a small office and billing operation. Covington said Bouza's case is fairly typical of the type of scheme he investigates.
"There's some insulation with the top level guys. It takes a little longer to get to them," Cantrell said.
Two recruiters hired Bouza and two other men, 50-year-old Leobaldo Perez Gonzalez of Miami and 31-year-old Alexander Castillo Dopico, as "nominee owners" to run small offices in Louisville and apply to become Medicare suppliers, giving them access to names of patients and doctors in the programs, according to Covington and the court records.
Covington said the men fit the profile of the type of person used in such a scheme — Cuban immigrants offered $5,000 to $15,000 to run a business.
"These are people who are interested in living the American dream," Covington said.
Bouza's company, Newberg Services, Inc., would eventually bill Medicare $750,000 for bandages and durable medical equipment that were never produced, Covington and court records say.
Covington said two physicians whose names were on billing records as prescribing physicians said they never heard of Newberg Services and that none of the beneficiaries were patients. The patients also said they never heard of the company and didn't receive any supplies from it.