Four South Floridians sentenced in health insurance fraud scheme

The four had filed false claims totaling more than $125 million and pocketed $13.9 million. Now: prison

Insurance News

By Lyle Adriano

For their involvement in two health care fraud schemes, two individuals from Miami and another two from Hialeah were sentenced to prison. The US Attorney’s Office for the Southern District of Florida announced the news Oct. 31. The four were among 15 people charged in the health care cases.

The individuals are Hendris Castillo Morales and Alejandro Biart of Miami, and Maite Garcia and Osvaldo Marin Medina of Hialeah. They were sentenced after their guilty pleas of participation in schemes to defraud private health care plans like Cigna, Blue Cross Blue Shield, and United Health Care.

Of the four, Morales is to serve the longest sentence: 10 years and 1 month in prison. Additionally, he was ordered to pay $13.9 million in recompense. The other three were all sentenced to 4 or fewer years in prison.

According to the indictment, the 4 sought more than $125.7 million from the plans for medical items and services which were not even ordered by physicians or provided to the beneficiaries as claimed. The health plans paid $13.9 million to reimburse the falsified claims, said the US Attorney’s Office.

The 4 managed to run their scheme from around October 2012 through February 2015. They meant to maintain a conspiracy to submit false claims to health care programs, conceal their falsehood, and use their ill-gotten gains for personal use, the indictment stated.

Keep up with the latest news and events

Join our mailing list, it’s free!