MIAMI – Federal authorities arrested nine people Tuesday, accusing them of orchestrating a $37 million South Florida-based health care fraud scheme.
For some of the suspects, the scheme was a family affair, prosecutors allege.
According to the U.S. Department of Justice, FBI agents 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.
All face multiple charges of conspiracy to commit health care fraud and health care fraud.
The group is accused of defrauding Blue Cross Blue Shield.
Prosecutors said the group paid kickbacks to beneficiaries of health insurance plans managed by Blue Cross, offering the kickbacks to employees of JetBlue Airways, AT&T and TJX Companies to induce them “to serve as patients at various South Florida physical therapy clinics.”
“The defendants who owned the clinics then submitted fraudulent health insurance claims to Blue Cross for health care benefits that were medically unnecessary and not even provided,” prosecutors said.
Members of the group are also accused of paying licensed massage therapists to act as “nominee owners” and operators of the physical therapy clinics, allowing them to avoid licensing requirements and to attempt to evade prosecution.
If convicted, each suspect faces up to 10 years in prison per count.