Crispin Abarientos, M.D., of Middletown, Connecticut, pleaded guilty to one count of health care fraud in Hartford federal court. According to court statements, Abarientos was a physician that operated out of Middlesex Rheumatology and submitted false claims to Medicaid regarding the use of the drug Remicade on behalf of his patients.
Remicade is primarily used to treat rheumatoid arthritis, and is a drug that was commonly prescribed to Middlesex Rheumatology patients. When Medicaid patients are treated with Remicade the prescribing physician is required to submit claims to their local Medicaid facility, in this case Connecticut Medicaid, on their behalf. Medicaid then pays a partnered pharmacy for the requested drugs, which are then delivered to the prescribing doctor’s facility.
While this was a procedure that Abarientos regularly followed for many of his patients, he admitted to submitting claims to Medicaid for large quantities of the drug that were never intended to be distributed to his patients. He would then submit claims to insurers for reimbursement of the drugs, profiting from the scheme without any out-of-pocket expenses. In total, Abarientos was able to obtain around $895,000 worth of Remicade, which were never distributed to his patients for treatment.