MIAMI – Federal prosecutors consider Arisleidys Fernandez Delmas to be the ringleader of a nearly $37 million health care fraud scheme based in South Florida. Now, the Miami woman is set to spend years behind bars and is on the hook for an enormous fine.
According to the U.S. Department of Justice, a judge sentenced Fernandez Delmas, who pleaded guilty to the scheme, to 104 months in federal prison and ordered her to pay $8,671,377 in restitution as part of a conspiracy to rip off Blue Cross Blue Shield for physical therapy services patients never received.
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Fernandez Delmas, 33, was one of 15 people charged in the scheme, many of whom were related. In addition to the prison time and fines, she’ll serve three years of supervised release.
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 co-conspirators “also paid kickbacks and bribes to their co-defendants in return for referring additional BCBS beneficiaries to the physical therapy clinics so more fraudulent health care claims could be submitted,” a news release states.
Officials said they also “paid licensed massage therapists — several of whom were among the defendants convicted — to act as ‘nominee owners’ and operators of the physical therapy clinics. This allowed the leaders of the scheme to avoid various medical clinic licensing requirements and attempt to evade criminal prosecution.”
The following additional defendants have pleaded guilty in connection with the case:
- Pedro Hugo Prieto Garcia, of Miami, “pleaded guilty on July 27, to conspiracy to commit health care fraud and health care fraud.” He “was sentenced on Oct. 16, to 87 months in prison, followed by three years of supervised release and ordered to forfeit $341,887.”
- Leidys Delmas Garcia, of Miami, “pleaded guilty on July 24, to conspiracy to commit health care fraud.” She “was sentenced on Oct. 16 to 68 months in prison, followed by three years of supervised release and ordered to forfeit $1,599,933.33.”
- Carlos Jose Martin Gomez, of Miami, “pleaded guilty on Oct. 12, to conspiracy to commit health care fraud.” He’s scheduled to be sentenced Jan. 3.
- Julio Acosta Perez, of Homestead, “pleaded guilty on June 14, to conspiracy to commit health care fraud.” He “was sentenced on Sep. 6, to 37 months in prison, followed by three years of supervised release and ordered to forfeit $822,524.21.”
- Yohana Iriza, alias Yohana Lozada, of Miami, “pleaded guilty on April 4, to conspiracy to commit health care fraud.” She “was sentenced on Aug. 4, to 33 months in prison, followed by three years of supervised release and ordered to forfeit $367,207.64.”
- Gabriel Lozada, of Fort Myers, “pleaded guilty on May 1, to conspiracy to commit health care fraud.” He “was sentenced on July 31, to 27 months in prison, followed by three years of supervised release and ordered to forfeit $255,694.16.”
- Emiliano Joaquin Garcia, of Lakeland, “pleaded guilty on April 18, to conspiracy to commit health care fraud.” He “was sentenced on Oct. 24, to 16 months in prison, followed by three years of supervised release.”
- Anthony Lozada, of Miami, “pleaded guilty on April 4, to conspiracy to commit health care fraud.” Lozada “was sentenced on Aug. 4, to 18 months in prison, followed by three years of supervised release and ordered to forfeit $223,604.78.”
- Daimara Borroto Garcia, of Hollywood, “pleaded guilty on May 4, to conspiracy to commit health care fraud. Borroto Garcia “was sentenced on Sep. 18, to 14 months in prison, followed by three years of supervised release.”
- Elias Caises Maurino, of Miami, “pleaded guilty on April 25, to conspiracy to commit health care fraud.” He “was sentenced on Aug. 9, to six months in prison, followed by three years of supervised release.”
- Linda Taylor, of Miami, “pleaded guilty on Aug. 28, to conspiracy to commit health care fraud.” Her sentencing hearing is scheduled for Nov. 17.
Three other defendants have made their initial appearances in federal court: Gabriel Jaime Mejia and Yarlon Valdes Morejon, both of Miami, and Ariel Gonzalez, of Naples.