Management Firm Heads Convicted in $1.4 Billion Healthcare Scheme

Earlier this week, a federal jury in the Middle District of Florida found the administrators of a fraudulent hospital management firm responsible for running a $1.4 billion billing scheme between 2015 and 2018.

Jorge Perez, 62, and Ricardo Perez, 59, engaged in a complex pass-through billing scheme involving rural hospitals in Florida, Georgia, and Missouri, according to the Justice Department. The pair promised to prevent the closure of these struggling medical facilities by repurposing them as laboratory testing sites. Once their hospital management firm settled agreements and purchases, Jorge and Ricardo increased the reimbursement rates for laboratory testing.

A 2017 audit of the local hospital in Putnam County, Missouri, revealed the scheme, according to State Auditor Nicole Galloway. The Missouri State Auditor's Office discovered $90 million in illegal billing sent through the 15-bed hospital, marking the largest fraud discovery in its history.

After a 24-day trial, the federal jury found Jorge and Ricardo guilty of conspiracy to commit health care fraud and wire fraud, five counts of health care fraud, and conspiracy to commit money laundering; they could serve up to 20 years in prison.

In a taskforce effort, the Federal Bureau of Investigation's (FBI) Jacksonville Field Office; Office of Personnel Management, Office of Inspector General (OPM-OIG); Department of Labor, Office of Inspector General (DOL-OIG); and the Amtrak Office of Inspector General investigated the case.