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Rheumatologist gets 3-year prison sentence for Medicaid fraud

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    Middletown (Hartford Business Journal) — A Middletown doctor has been sentenced to more than three years in prison for filing false Medicaid claims that helped him obtain almost $900,000 worth or prescription medications.

U.S. District Judge Vanessa L. Bryant on Wednesday sentenced Dr. Crispin Abarientos, 45, to 37 months in prison, and two years of supervised release, for defrauding Connecticut’s Medicaid program.

According to court documents, Abarientos owned and operated a medical practice called Middlesex Rheumatology in Middletown.

From Sept. 2013 to Jan. 2018, Abarientos and his medical practice submitted to Connecticut’s Medicaid program false claims for the delivery of Remicade, an injectable prescription medication meant to treat rheumatoid arthritis, on behalf of his Medicaid patients, even though they weren’t being treated with the drug.

Medicaid sent payment to Caremark Massachusetts Specialty Pharmacy, which delivered the Remicade contained in the claim to Middlesex Rheumatology for the Medicaid patient without any out-of-pocket expense to Abarientos.

The scheme reaped Abarientos approximately $894,789 worth of Remicade, and he instead used the drug on other patients, such as those with Medicare or commercial insurance, and submitted claims to those insurers for reimbursement, keeping the profits, prosecutors say.

Abarientos attempted to hide the scheme from investigators by submitting falsified medical records that made it appear as though patients he used to obtain the Remicade from Medicaid were being treated with the medication when they were not.

Abarientos pleaded guilty to one count of healthcare fraud in June, and was released on a $100,000 bond. He’s required to report to prison on Jan. 8.

Meantime, Abarientos has paid $894,789 in restitution, and is negotiating with the federal and state government to resolve other civil fraud allegations, according to the U.S. Attorney’s Office.

The scheme is being investigated by the FBI, Office of the Inspector General of the U.S. Department of Health and Human Services, the Medicaid Fraud Control Unit of the Chief State’s Attorney’s Office and the Connecticut Office of the Attorney General.

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CNN

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