By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
4.5 Year Sentence for Role in Fraud.
A Miami Man voluntarily returned to Miami from Cuba and was immediately met with a 4.5-year long prison sentence. Jose Gerardo Gonzalez, played a role in a scheme to defraud public schools and private health care insurers of $126 million.
Gonzalez allegedly created shell companies that submitted false health care claims. The private insurers were ultimately at lose for millions of dollars. Gonzalez fled to Cuba in 2015 after being charged with conspiracy and other charges. Upon voluntary return to Florida he is sentencing was reduced.
William Barzee, Gonzalez’s attorney, states its uncommon for fugitives to return once they flee to Cuba. However, our experience has been just the opposite. In our experience, quite a few individuals flee to Cuba, which has no extradition treaty with the U.S., after being notified of an investigation of Medicaid or Medicare fraud charges.
The Restitution.
The sentence included 4.5 years in prison and restitution of $13.9 million. In addition, two properties owned by Gonzalez worth several hundreds of thousands of dollars were been seized.
Conspiracy lead remains in Cuba.
Reynaldo Castillo is considered the conspiracy’s leader “employing” several people. Gonzalez played a role in a scheme to target employers offering “administrative services only” insurance plans to their employees. Gonzalez, along with several other individuals, registered businesses in his or her name and opened bank accounts and cashed checks bilking insurers. Insurers that sustained losses include Cigna, Blue Cross Blue Shield, and United Healthcare. Gonzalez and 15 other Miami residents were charged. But Reynaldo Castillo is still believed to be in Cuba, avoiding sentencing.
The conspirators submitted false claims to the insurers using medical director staffing companies to misappropriate doctors licensing information. This is something we are constantly warning physicians against, allowing someone else to use and bill under their name and provider identification numbers.
Health Care Fraud Should Not Be Taken Lightly.
We have been consulted by many individuals, both before and after criminal convictions for fraud or related offenses. In many cases, those subject to Medicaid or Medicare fraud audits and investigations refuse to acknowledge the seriousness of the matter. Individuals facing Medicare and Medicaid criminal charges should realize the severity of the offense. Some may even decide not to spend the money required for a highly experienced health attorney as part of the legal team to help defend them.
The government is serious about combating health care fraud. False claims are a growing problem in the program, costing the government billions of dollars each year. Punishments for defrauding the system can be quite severe.
If you are accused of Medicaid or Medicare fraud, realize that you are in a fight for your life. Your liberty, property/possessions and profession are all at stake. Often a Medicaid Fraud investigation will begin with a notification from the investigator. From that point on, all action to obtain legal representation should be made. The investigator will use all information from that point on against you. Be prepared to give up whatever you need to in order to avoid a conviction and preserve your liberty.
To read further about the seriousness of health care fraud you can read additional blogs of mine here.
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Sources:
Crosby, Christopher. “Miami Man In $126M Health Fraud Ring Gets 4.5 Years – Law360.”Law360 – The Newswire for Business Lawyers. LexisNexis, 13 June 2017. Web. 03 July 2017.
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