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Tropical Paradise

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Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

Fraudsters often live in a make-believe world. They tend to think that their illegal actions will bring them great wealth and a relaxing lifestyle on some tropical island. (And they really don’t care if they hurt anyone in the process.)

Dr. Americao Oms-Rivera, 67, who was already living in a tropical location in Puerto Rico, pleaded guilt to Social Security fraud. He created backdated medical records for patients who were applying for disability insurance benefits by certifying false medical appointments took place. This created the illusion that these patients had been receiving medical treatment for some time. (He was hoping the Social Security Administration (SSA) would be tricked into approving disability insurance benefits.)

Dr. Oms-Rivera had accomplices. (Fraudsters usually do.) His secretary, Mayte González Muñoz and a former SSA employee, Francisco Cabrera Alvarado, helped carry out the Social Security fraud scheme. (This threesome probably shared a dream of sipping drinks out of coconuts while lying beside an infinity pool under a colorful umbrella.)

The SSA provides monetary benefits to qualified workers with severe, long-term disabilities through the Disability Insurance Benefits Program. Even spouses and dependent children of disabled workers can be eligible to receive benefits from the program, so you can understand how fraud schemes, such as this one, can impact those who are in need.

Dr. Oms-Rivera pleaded guilty to Social Security fraud and was sentenced to five years of probation. (It sounds like he got off easy, but he actually didn’t.) He will also have to pay $321,000 in restitution to the SSA and another $7,500 fine.

In addition to the probation and restitution, the doctor will forfeit a property located in Harbour Lights Estate in Palmas Del Mar, Humacao, PR. (Let’s just say, it’s near the water in a tropical paradise. Easy come, easy go.) He will also surrender his DEA license and will not be able to participate in SSA case assessments, Medicare, Medicaid or any other federal health care benefit programs, ever again. (Sounds like justice has been served.)

Another bit of good news is that González-Muñoz and Cabrera Alvarado also plead guilty to committing Social Security fraud. Congratulations to the team of law enforcement who put a halt to this selfish scheme to defraud the government and taxpayers.

Today’s Fraud of the Day comes from a Department of Justice press release, “Doctor Sentenced For Social Security Fraud,” dated February 5, 2021.

SAN JUAN, P.R. – Doctor Americo Oms-Rivera, 67, was sentenced to five years of probation by United States District Judge Francisco A. Besosa for conspiracy to commit wire fraud, announced W. Stephen Muldrow, United States Attorney for the District of Puerto Rico. Oms-Rivera plead guilty to conspiracy to commit wire fraud on October 23, 2020.

As part of the sentence imposed, Oms-Rivera will pay $321,000 in restitution in favor of the Social Security Administration (SSA) and a $7,500 fine to be paid in 60 days. Oms-Rivera will also forfeit a property in Harbour Lights Estate in Palmas Del Mar, Humacao, PR, will surrender his DEA license and will be excluded from participating in SSA case assessments, Medicare, Medicaid and all other federal health care benefit programs.

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