Nine Florida residents were arrested this Tuesday by the Federal Bureau of Investigation (FBI) after being accused of orchestrating a health fraud scheme of 37 million dollars in the south of the state.
They facevarious conspiracy chargesto commit health care fraud and fraudArisleidys Fernández Delmas, 32 years old; his motherLeidys Delmas García, 51 years old; her husbandPedro Hugo Prieto García, 32 years old;Daimara Borroto García, 32 years old;Elias Caises Maurino, 52 years old;Yohana Iriza (alias Yohana Lozada), 51 years old; her ex-husbandGabriel Lozada, 50 years old; your sonAnthony Lozada, 23 years old; and J.ulio Acosta Perez, 40 years old, noted the Department of Justice of the Southern District of Florida in astatementissued this Tuesday.
According to the information provided by the prosecution, the group would have conspired toscam about 37 million dollarsin health care claims to the insurance companyBlue Cross Blue Shield, by 30 physiotherapy clinics.
The individuals - who presumably have blood ties -They have paid bribes to beneficiaries since 2018of health insurance plans administered by Blue Cross and offered these kickbacks to employees ofJetBlue Airways, AT&T Inc. y TJX Companies Inc. to induce them to serve as patients in several South Florida physical therapy clinics.
The accused clinic owners subsequently submitted fraudulent health insurance claims to Blue Cross forhealthcare benefits that were medically unnecessary and they had not even been provided.
Members of the group are also accused ofpay licensed massage therapists to act as "nominal owners" and operators of the physical therapy clinics, allowing them to avoid medical clinic licensing requirements and legal action.
This allowed the ringleaders to circumvent various licensing requirements for medical clinics and attempt to avoid criminal action.
If convicted, suspects face a sentenceup to 10 years in prison for each charge.
If convicted, each faces up to 10 years in prison on each count. A federal district judge will determine the sentence after considering the US Sentencing Guidelines and other legal factors.
Several cases of health scams have previously emerged on social networks and on official US government sites.
A 61-year-old man,Julius Arsenio Rodriguez, earned millions of dollars in proceeds by defrauding the government's Medicare and Medicaid programs through multiple clinics located throughout South Florida that allegedly provided durable medical equipment (DME) to eligible beneficiaries.
For scamming the same companies, anotherMiami businessman was convictedto more than seven years in prison after he created a shell company called Myers Professional Services, based in Ft. Myers, Florida, and for trying to conceal his crime by declaring a false owner in corporate and bank records.
The man purchased lists of Medicare "patients" and then directed a "biller" to submit fraudulent claims to that health benefits program for durable medical equipment that was not being prescribed by a doctor, that was not medically necessary, and that they were not being provided to any Medicare or Medicaid beneficiaries.
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