What happened to the head of a $36 million Miami fraud involving AT&T, JetBlue employees
A $36 million healthcare scheme involved 30 clinics in Miami-Dade, Hialeah, Doral and Tampa. At least 12 people became white collar criminals. They used employees of three corporations.
And, for the Miami woman running the massive financial fraud involving billing for services not done or unnecessary, it has come down to two numbers: 104 months and $8,671,377.
The eight years and eight months is the federal prison sentence for 33-year-old Arisleidys Fernandez Delmas handed down in Miami federal court Thursday. And the money is the restitution part of Fernandez’s sentence after she pleaded guilty to healthcare fraud and conspiracy to commit healthcare fraud.
READ MORE: Nine arrested in $37 million health care scheme in Miami. Is your clinic on the list?
Fernandez’s guilty plea and sentencing officially puts the conspiracy at 12, with three others indicted and having made their first appearance. In addition to Fernandez, the fraud includes:
▪ Fernandez’s common law husband, Pedro Hugo Prieto Garcia, 33, who was sentenced on Oct. 16 to seven years, three months for conspiracy to commit healthcare fraud and healthcare fraud. Prieto also lost $341,887 in forfeiture.
▪ Fernandez’s mother, Leidys Delmas Garcia, who was sentenced on Oct. 16 to five years, eight months in prison and ordered to forfeit $1,599,933 cash after pleading guilty to conspiracy to commit healthcare fraud.
▪ Miami’s Carlos Jose Martin Gomez is scheduled to be sentenced Jan. 3 after pleading guilty to conspiracy to commit healthcare fraud.
▪ Homestead’s Julio Acosta Perez, 41, who got three years and one month in prison and ordered to forfeit $822,524 after pleading guilty to conspiracy to commit healthcare fraud.
▪ Miami’s Yohana Iriza, aka Yohana Lozada, a 52-year-old who got two years, nine months in prison and told to forfeit $367,207 after pleading guilty to conspiracy to commit healthcare fraud.
▪ Fort Myers’ Gabriel Lozada, 51, pleaded guilty to conspiracy to commit healthcare fraud and got two years, three months in prison and ordered to forfeit $255,694.16.
▪ Lakeland’s Emiliano Joaquin Garcia got a year and four months after pleading guilty to conspiracy to commit healthcare fraud.
▪ Miami’s Anthony Lozada, 24, pleaded guilty to conspiracy to commit healthcare fraud and got a year and six months and made to forfeit $223,604.78.
▪ Hollywood’s Daimara Garcia got a year and two months in prison after pleading guilty to conspiracy to commit health care fraud.
▪ Miami’s Elias Caises Maurino, 52, got six months in prison for conspiracy to commit healthcare fraud.
▪ Miami’s Linda Taylor is scheduled to be sentenced Nov. 17 after pleading guilty to conspiracy to commit healthcare fraud.
Naples’ Ariel Gonzalez, Miami’s Yarlon Valdes Morejon and Gabriel Jaime Mejia have made their first appearances.
AT&T, T.J. Maxx, Marshalls, JetBlue, Blue Cross Blue Shield and fraud
Fernandez’s admission of facts says the fraud’s marks were health insurance plans managed by Blue Cross Blue Shield and provided to employees of AT&T, JetBlue Airways and TJX Companies, the parent company of T.J. Maxx, Marshalls, HomeGoods, Sierra and Homesense stores.
Fernandez, her mother, her father and Perez set up 30 fraudulent clinics. Some physical therapists “allowed their licenses to be used to bill Blue Cross Blue Shield for services not rendered.” Joaquin, Mejia and others acted as patient recruiters, including paying kickbacks to employees of the companies “in exchange for allowing the fraudulent clinics to bill their insurance plans for physical therapy services” that were unnecessary or never done; and patient beneficiaries who took the kickbacks.
Then, it was all about the billing. Through the clinics, this gang billed Blue Cross about $36,728,595, and Blue Cross paid about $8,671,377 to the clinics for the fraudulent claims.
The investigation was handled by the FBI’s Miami office. The cases have been prosecuted by Assistant U.S. Attorneys Will J. Rosenzweig and Michael B. Homer with Assistant U.S. Attorney Annika Miranda doing the asset forfeiture.