July 3, 2022

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South Florida Overall health Care Clinic House owners, Doctor, Other people Sentenced in Healthcare Billing Fraud Scheme | USAO-SDFL

Miami, Florida – Yesterday, a federal district decide in Miami sentenced the very last of 10 defendants for her part in a well being care fraud plan involving a few physical therapy clinics that recruited and paid out kickbacks to beneficiaries of Blue Cross Blue Defend wellness reward courses (BCBS) and submitted phony statements to BCBS for providers that the clinics under no circumstances provided to the beneficiaries or ended up not medically required. 

The a few South Florida clinics associated in the scam were being Everyday living Blue Professional medical Centre, Corp. (“Life Blue”), Blue Everyday living Professional medical Middle, LLC (“Blue Life”), and Miami Healthcare Remedy (“Miami Medical”). The defendants, all South Florida residents now convicted and sentenced, include clinic owners, a physician, individual recruiters, a actual physical therapist assistant, and an business staff. 

The conspiracy resulted in far more than $17 million in untrue claims being billed to BCBS, of which BCBS paid shut to $5 million.  Most of the statements had been for unneeded or in no way-furnished electrical stimulation, ultrasound remedy, therapeutic exercising, and other bodily remedy procedures, as perfectly as for allergy assessments and sturdy professional medical tools.  The conspirators spent the income they received from BCBS on private things and to further the fraud.

Every single defendant earlier pled responsible to 1 depend of conspiracy to commit wellbeing treatment fraud.  United States District Judge K. Michael Moore sentenced the defendants as follows:

  • Jorge Gonzalez Perez, 57, (proprietor of Daily life Blue and Blue Life clinics) was sentenced to 120 months in prison, adopted by 3 a long time supervised release, and ordered to spend $4,143,892.16 in restitution
  • Orlando Leiva, 66, (a health practitioner at Lifestyle Blue and Miami Professional medical) was sentenced to 57 months in prison, adopted by three years supervised release, and ordered to shell out $2,867,770.57 in restitution
  • David Vladimir Sacerio, 30, (co-proprietor of Miami Professional medical) was sentenced to 51 months in prison, followed by 3 decades supervised release, and requested to pay $686,086.33 in restitution
  • Kiamy Perez, 36, (co-owner of Miami Professional medical) was sentenced to 34 months in prison, followed by 3 several years supervised release, and requested to shell out $686,086.33 in restitution
  • Enry Guzman, 43, (affected person recruiter) was sentenced to 33 months in prison, followed by 3 many years supervised launch, and requested to fork out $228,075.73 in restitution
  • Kyrenia Maquiera Rodriguez, 40, (bodily therapy assistant) was sentenced to 30 months in jail, followed by three decades supervised release a few a long time supervised launch, and requested to pay out $686,086.33 in restitution
  • Freymil Lozada, 34, (individual recruiter) was sentenced to 27 months in jail, adopted by 3 many years supervised release, and requested to spend $184,393.52 in restitution and
  • Haniel Rodriguez, 45, (individual recruiter) was sentenced to 24 months in jail, adopted by 3 several years supervised release, and requested to pay out $198,540.57 in restitution.

Two defendants ended up requested to fork out restitution: Brian McIntosh, 53, (affected person recruiter) in the amount of money of $119,174.66, and Melissa Cruz, 21, (Miami Professional medical office environment personnel) in the sum of $686,086.33.

Juan Antonio Gonzalez, U.S. Lawyer for the Southern District of Florida, and George L. Piro, Exclusive Agent in Demand, FBI Miami, manufactured the announcement.

FBI Miami investigated the situation.  Assistant U.S. Legal professional Shannon Shaw prosecuted the case.  Assistant U.S. Attorney Annika Miranda is managing asset forfeiture.

Connected courtroom files and data may perhaps be identified on the internet site of the District Court for the Southern District of Florida at www.flsd.uscourts.gov or at http://pacer.flsd.uscourts.gov, under case number 21-cr-20376.

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