Florida Men Convicted In Billing Scheme Involving Putnam County Hospital
Two Miami, Florida men have been convicted by a federal jury of their roles in a conspiracy that fraudulently billed $1.4 billion dollars of laboratory testing services in a pass-through billing scheme that included rural hospitals. The Putnam County Memorial Hospital in Unionville was one of those hospitals.
The U.S. Attorney’s Office of the Middle District of Florida says 62-year-old Jorge Perez and 59-year-old Ricardo Perez of Miami were convicted of working together to unlawfully bill nearly $1.4 billion dollars of laboratory testing services which were medically unnecessary and used rural hospitals as shells when the services were actually done at outside laboratories.
Information from the 24-day trial indicated says the two men sought out vulnerable and distressed hospitals and brokered management agreements so that private insurance contracts used by those hospitals would obtain higher reimbursement rates for laboratory testing. The defendants promised to save these rural hospitals from closure by turning them into laboratory testing sites, but instead billed for fraudulent laboratory testing worth hundreds of millions of dollars in a sophisticated and years-long “pass-though” billing scheme. The scheme made it appear that the rural hospitals themselves did the laboratory testing when, in most cases, it was done by testing laboratories controlled by certain defendants.
The men were convicted of conspiracy to commit health care fraud and wire fraud, 5 counts of health care fraud, and conspiracy to commit money laundering of more than $10,000. The defendants face a maximum penalty of 20 years for each of the health care fraud and wire fraud conspiracy and money laundering conspiracy counts, and 10 years for each substantive health care fraud count. Sentences will be announced later.
The other hospitals used in the fraud scheme included hospitals in Graceville and Williston, Florida, and Dahlonega, Georgia
The Missouri State Auditor’s Office uncovered information on the scheme in a 2017 audit of the hospital.
