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CT Rheumatologist Admits To Defrauding Medicaid Program

Middlesex Rheumatology in Middletown. Photo Credit: Google Maps street view
U.S. Federal Court in Hartford. Photo Credit: File

A rheumatologist in Connecticut is facing a decade behind bars after admitting to defrauding a Medicaid program of nearly a million dollars.

Middletown resident Crispin Abarientos, 44, who owns and operates Middlesex Rheumatology in Middletown, pleaded guilty in Hartford federal court to one count of health care fraud after he ran a scheme that netted him $894,789.

According to U.S. Attorney John Durham, 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 last year, 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.

Abarientos is scheduled to be sentenced on Oct. 30, when he will face up to 10 years in prison.

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