Upon completion of this Case Study, participants
White-collar professionals, business owners that should learn more about federal laws.
Healthcare Fraud, Unlimited Medical Research, Dr. Yvelice Villaman Bencosme, Lisett Raventos, Wire Fraud, Conspiracy,
In January 2021, the U.S. Justice Department (DOJ) published a report to review prosecutions in healthcare fraud. The DOJ’s prosecution efforts identified more than $6 billion in false and fraudulent healthcare claims. The DOJ indicated the efforts in 2020 have been the largest healthcare fraud enforcement action in the department’s history.
The cases involved a large variety of medical doctors, healthcare providers, medical researchers and other individuals who unwittingly became involved in criminal activities. In this case study, we learn from two MD’s that allowed their greed to overcome good decision-making, resulting in severe prison sentences.
This case study profiles Unlimited Medical Research, LLC (Unlimited)
According to the Justice Department, Unlimited Medical Research, LLC (Unlimited), began operations in 2013. The company employed Dr. Bencosme. He served as the primary researcher for clinical trials. Raventos, another medical doctor, served as the site director, director of clinical operations, and a study coordinator at Unlimited.
The FDA has been a part of the Department of Health and Human Services (HHS) since Congress created the agency in 1939. The agency’s rules ensure the safety, efficacy, and security of drugs, products, and medical devices intended for human use. The primary focus of the FDA has been enforcement of the Federal Food, Drug, and Cosmetic Act (FD&C).
After FDA investigators began asking questions, the defendants admitted to investigators that they had been fabricating data in the clinical trials. The fabricated data related to a clinical trial on the safety of a new asthma medication designed to prevent and treat asthma in children aged 4 to 11. Doctors Bencosme and Raventos engaged in widespread fraud. Their alleged crimes included falsifying medical records for dozens of nonexistent pediatric patients.
According to FDA investigators, these defendants fabricated records of patients that, ostensibly, attended medical appointments at their research center. They also admitted to creating medical data from these medical appointments. When Bencosme and Raventos submitted this falsified data to the pharmaceutical company, the pharmaceutical company would pay them for the fake research.
As a result of the FDA’s investigation, federal prosecutors at the Justice Department brought criminal charges against Bencosme and Raventos. They charged each defendant with one count of conspiracy to commit wire fraud.
A criminal conspiracy takes place when two or two or more people agree to commit an unlawful act. Wire fraud involves the use of some form of telecommunications or the internet, including a phone call, a fax, an email, a text, or social media messaging. Wire fraud carries a possible punishment of up to 30 years in federal prison. Both defendants pled guilty to the criminal charge.
As a direct result of their criminal behavior, Bencosme received a sentence of 63 months in prison. The judge sentenced Raventos to 30 months in prison. Both defendants lost their license to practice medicine.
The facts of this case do not reveal whether Unlimited had a compliance training system in place. We recommend that all businesses, particularly those businesses that operate in highly-regulated industries, like healthcare, implement compliance training. Those compliance training programs should include lessons in the ways that government investigations begin, and how people can make decisions on the job that bring severe consequences.
Our team at Compliance Mitigation works with people that face charges for white-collar crime regularly. Many of those people argue that they did not understand the full ramifications of their decisions; they certainly did not view their behavior through the same lens as a prosecutor.
American prisons incarcerate many business professionals that profess ignorance of the law. For these reasons, we highly recommend compliance training that helps people understand more about white-collar crime.
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