From a press release:
On August 2, 2016 a Federal Grand Jury in the District of Puerto Rico returned a 16-count indictment charging one doctor, Americo Oms-Rivera, his secretary Mayte González Muñoz, and Francisco Cabrera Alvarado, a former Social Security Administration (SSA) employee, for fraud in the application process for SSA disability insurance benefits in Puerto Rico, announced United States Attorney for the District of Puerto Rico, Rosa Emilia Rodríguez Vélez. ...
The indictment alleges that on or about September 24, 2013, Person A was introduced to Oms-Rivera to discuss his intentions of applying for disability insurance benefits. During said meeting, Oms-Rivera informed Person A that he/she needed to seek treatment for a period of five to six months before the paperwork was submitted to SSA. Oms-Rivera told Person A that once Person A’s disability benefits were approved, he would take a percentage of the check as payment. The scheme involved, among others, the following acts alleged in the indictment:
On or about January 14, 2014, Person A had the first medical appointment with Oms-Rivera. During this visit, Person A informed the doctor that he/she was interested in obtaining SSA disability insurance benefits. Person A reported that his/her medical conditions were high blood pressure and migraines from time to time. In response, Oms-Rivera prescribed Prozac, a non-controlled narcotic, used for depression and panic disorders and Restoril, a Scheduled IV narcotic used to treat insomnia symptoms.
Person A made additional visits to Oms-Rivera for purported medical treatment. During these visits, Oms-Rivera and Person A discussed the disability application process and Oms-Rivera prescribed Prozac, a non-controlled narcotic, used for depression and panic disorders; Restoril, a Scheduled IV narcotic, used to treat insomnia symptoms; Ambien, a Scheduled IV narcotic, used to treat insomnia; and Xanax, a Scheduled IV narcotic, used to treat anxiety and panic disorders.
Oms-Rivera and defendant González-Muñoz referred Person A to Cabrera, a former SSA employee who worked as a non-attorney representative. Cabrera assisted Person A in his application for SSA disability insurance benefits.
On May 21, 2014, Cabrera met with Person A in order to assist him/her to fill out the Adult Function Report, SSA Form 3373. During said meeting, Cabrera coached Person A as to what to write in the form in order to get Person A’s disability benefits approved.
On June 10, 2014, González charged Person A $600 for the Psychiatric Medical Report and $1,440 for backdating his/her medical file and creating 24 fictitious medical appointments.
On or about October 22, 2015, the Psychiatric Medical Report signed by Oms-Rivera was submitted to SSA indicating that Person A was totally disabled to return to work as of that date or in the near future. In the Psychiatric Medical Report, Oms-Rivera falsely represented to SSA that Person A’s first medical visit was on October 15, 2013. Oms-Rivera further reported a total of approximately 11 fictitious appointments that never took place. This was done to create the appearance of a longer history of medical treatment.