Miami men convicted of health care fraud scheme targeted local hospital

Two Miami men have been convicted in a $1.4 billion health care fraud scheme targetting a rural...
Two Miami men have been convicted in a $1.4 billion health care fraud scheme targetting a rural hospital in Graceville.(WJHG)
Published: Jul. 5, 2022 at 3:28 PM CDT
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FORT MYERS, Fla. (WJHG/WECP) - Two Miami men have been convicted in a $1.4 billion health care fraud scheme targetting a rural hospital in Graceville and others.

Jorge Perez, 62, and Ricardo Perez, 59, unlawfully billed for approximately $1.4 billion of laboratory testing services that were deemed medically unnecessary. They also committed health care fraud on five occasions and conspired to launder the proceeds of the scheme.

The evidence showed the Perezes targeted and obtained control of financially distressed rural hospitals through management agreements and purchases. The defendants sought to obtain control of these rural hospitals because of private insurance contracts that provided for higher reimbursement rates for laboratory testing, a common feature of rural hospital contracts designed to ensure that the hospitals can survive and provide rural communities with much-needed care. The defendants promised to save these rural hospitals from closure by turning them into laboratory testing sites but instead billed for fraudulent laboratory testing worth hundreds of millions of dollars in a sophisticated and years-long “pass-through” billing scheme. The scheme made it appear that the rural hospitals themselves did the laboratory testing when, in most cases, it was done by testing laboratories controlled by certain defendants.

Three other rural hospitals in Florida, Georgia, and Missouri were also targeted.

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