A Failed Eight-man Defense

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Cropped shot of a doctor talking to a senior patient in a clinic

Alberto Orian Gonzalez-Delgado, 46, of Miami, Fla., has been sentenced after conspiring to commit health care fraud and wire fraud.

Co-conspirators including Eduardo Rubal, 41, Vicente Gonzalez Acosta, 50, Alexander Fernandez, 49, Yaxing Tapanes, 24, Jose Carlos Valladares Rivera, 43, Hector Suarez Gonzalez, 45, and Antonio Jimenez, 54, have all been sentenced according to their role in the scheme as well. The men received between 48 and 210 months in prison. (At least they will have friends during their stay in prison.)

The eight men conspired to run a fraud and money laundering organization in Florida and Michigan. As part of the operation, the team illegally billed Medicare for more than $80 million. The fraudsters received $53 million.

Here’s how it all went down. The co-conspirators recruited and directed nominee owners to purchase home health agencies. They were also instructed to open sham corporations in their names. After acquiring the home health agency, the eight men began to bill Medicare for services. (No surprise here – these services were never actually provided. In fact, there was no medical staff to support the claims.) 

After receiving funds, the group went through layers of shell companies and bank accounts so they could launder the money before transitioning it to cash at ATMs and Miami-based check-cashing stores. The eight men demanded that the nominee owners move to Cuba after they completed their work. (Despite thinking this would help them avoid detection and get them out of U.S. jurisdiction, the co-conspirators were still caught before they could leave the country.)

Unfortunately, the eight-man defense failed. On March 4, 2021, Gonzalez-Delgado pleaded guilty to his alleged actions and has been sentenced to 210 months in prison.

Today’s Fraud of the Day comes from a Department of Justice press release, “Final Defendant Sentenced in $80 Million Health Care Fraud Conspiracy,” dated May 27, 2021.

A Florida man was sentenced today to 210 months in prison for conspiracy to commit health care fraud and wire fraud.

Alberto Orian Gonzalez-Delgado, 46, of Miami, pleaded guilty to conspiracy to commit health care fraud and wire fraud on March 4. Gonzalez-Delgado is the last remaining defendant in this case to be sentenced. Eduardo Rubal, 41, of Miami, pleaded guilty to conspiracy to commit health care fraud and wire fraud and was sentenced to 210 months; Vicente Gonzalez Acosta, 50, of Miami, pleaded guilty to conspiracy to commit health care fraud and wire fraud and was sentenced to 188 months; Alexander Fernandez, 49, of Miami, pleaded guilty to conspiracy to commit money laundering and was sentenced to 120 months; Yaxing Tapanes, 24, of Hialeah, pleaded guilty to conspiracy to commit money laundering and was sentenced to 97 months; Jose Carlos Valladares Rivera, 43, of Miami, pleaded guilty to conspiracy to commit money laundering and was sentenced to 97 months; Hector Suarez Gonzalez, 45, of Hialeah, pleaded guilty to conspiracy to commit health care fraud and wire fraud and was sentenced to 78 months; Antonio Jimenez, 54, of Hialeah, was sentenced to 48 months.

 

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Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.