9 Floridians accused of arranging a $37M health care fraud scheme
The FBI said they arrested Arisleidys Fernandez Delmas, 32, her mother Leidys Delmas Garcia, 51, her husband Pedro Hugo Prieto Garcia, 32, Daimara Borroto Garcia, 32; Elias Caises Maurino, 52; Yohana Iriza, 51, her ex-husband Gabriel Lozada, 50, their son Anthony Lozada, 23, and Julio Acosta Perez, 40, on Tuesday night. The group was charged by a federal grand jury in Miami with health care fraud and conspiracy to commit health care fraud. (WPEC)
MIAMI (CBS12) — Nine Florida residents were arrested after the Department of Justice said they committed a $37 million health care fraud scheme.
The group was charged by a federal grand jury in Miami with health care fraud and conspiracy to commit health care fraud.
See also: 'Brazen execution-style:' Man found dead, shot in car in West Palm Beach
Officials said the group conspired to submit approximately $37 million in fraudulent health care claims to Blue Cross Blue Shield. From approximately 2018 until now, the defendants allegedly paid kickbacks to beneficiaries of health insurance plans managed by Blue Cross.
According to investigators, the nine offered these kickbacks to employees of JetBlue Airways, AT&T Inc., and TJX Companies Inc. to induce the beneficiaries to serve as patients at various South Florida physical therapy clinics. This allowed the group who owned the clinics to submit fraudulent health insurance claims to Blue Cross for health care benefits that were medically unnecessary and not even provided.
See also: Broward Sheriff's Office employee accused of defrauding people out of nearly $19,000
According to the DOJ, the group also allegedly paid kickbacks and bribes to their co-defendants in return for referring additional Blue Cross beneficiaries to the physical therapy clinics so more fraudulent health care claims could be submitted.
And, they're accused of using paid licensed massage therapists to act as "nominee owners." This allowed the nine to avoid various medical clinic licensing requirements and attempt to evade criminal prosecution.
The FBI said they arrested Arisleidys Fernandez Delmas, 32, her mother Leidys Delmas Garcia, 51, her husband Pedro Hugo Prieto Garcia, 32, Daimara Borroto Garcia, 32; Elias Caises Maurino, 52; Yohana Iriza, 51, her ex-husband Gabriel Lozada, 50, their son Anthony Lozada, 23, and Julio Acosta Perez, 40, on Tuesday night.
The indictments charge each defendant with multiple counts of conspiracy to commit health care fraud and health care fraud. The DOJ said the defendants could face up to 10 years in prison for each count.