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Middletown resident Crispin Abarientos, and his wife, Antonieta Abarientos, have reached a civil settlement with the federal and state governments in which they will pay $4,927,903 to resolve allegations that they violated the federal and state False Claims Acts.
Crispin Abarientos and his wife owned and operated Middlesex Rheumatology in Middletown, which specialized in the diagnosis and treatment of arthritis, autoimmune diseases, and related conditions, U.S.Attorney John Durham said. He was the treating physician at the practice and she was a part-owner of the practice.
Durham said that one of the medications that Abarientos prescribes to his Middlesex Rheumatology patients is Remicade, an injectable prescription medication used to treat rheumatoid arthritis.
When treating Medicaid patients with Remicade, Abarientos is required to submit a claim to the Connecticut Medicaid for Remicade on behalf of each patient. Durham said that Medicaid then sent payment to Caremark Massachusetts Specialty Pharmacy, which delivered the Remicade in the claim directly to Middlesex Rheumatology for the Medicaid patient without any out-of-pocket cost to Abarientos.
From September 2013 through January 2018, Abarientos and his practice submitted false claims for the delivery to Middlesex Rheumatology of Remicade for patients that weren’t being treated with Remicade.
Durham said that "Abarientos then proceeded to infuse the fraudulently obtained Remicade into Medicare patients or patients with commercial insurers, and submitted claims to those insurers for reimbursement, which he was able to keep as profit for himself.”
In an effort to hide the scheme for investigators, Abarientos submitted documents that were falsified to make it appear as if his patients were being treated with the medication, which they were not.
To resolve the allegations under the federal and state False Claims Acts, Crispin and Antonieta Abarientos have agreed to pay $4,927,903, which covers claims submitted to the Medicaid program from September 2013 through January 2018, and claims submitted to the Medicare program and the Connecticut State Employees Health Plan from July 2013 through June 2017.
“Physicians who participate in the Medicare and Medicaid programs must bill their services honestly, and the failure to do so increases the cost of health care for all of us,” Durham said. “Health care providers who submit false claims to federal health care programs face serious consequences.”
Crispin Abarientos previously pleaded guilty to health care fraud in a separate case and was sentenced to 37 months of imprisonment in October last year.
“We will not tolerate medical professionals stealing precious dollars from our federal health care programs,” FBI Special Agent in Charge Brian Turner said. “Together with our state and federal law enforcement partners, we will continue to swiftly investigate these schemes, to ensure that waste, fraud, and abuse in our Medicaid program is uncovered and those responsible are punished accordingly.”
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