Florida health clinic owner sentenced in $36 million fraud scheme that recruited fake patients

Florida health clinic owner sentenced in $36 million fraud scheme that recruited fake patients

The health care fraud operation also recruited licensed massage therapists to help bill for services that did not happen.

Kinsey Crowley

A Florida woman has been sentenced to more than eight years in prison for her role in a health care fraud conspiracy that brought in $8.6 million.

Arisleidys Fernandez Delmas, 33, is the lead defendant in a federal case against 15 individuals that were allegedly involved in the scheme, according to the U.S. Attorney’s Office in Miami. She pleaded guilty to health care fraud and conspiracy to commit health care fraud in a plea deal in July. Eleven other defendants also pleaded guilty, the Department of Justice said in a Friday news release.

Court records show Fernandez Delmas and the defendants billed $36 million to insurer Blue Cross Blue Shield for physical therapy services that were not necessary or provided.

She was sentenced to eight years and eight months in prison, followed by three years of supervised release. She will also have to pay $8,671,377 in restitution. The attorneys representing her did not immediately respond to USA TODAY’s emailed request for comment Monday.

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Inside the health care fraud scheme that billed over $36 million

From October 2018 to November 2022, Fernandez Delmas and other leaders in the scheme recruited employees of JetBlue Airways, AT&T Inc., and TJX Companies Inc, all members of health care benefit programs managed by Blue Cross Blue Shield, court records show.

The employees were offered compensation to act as patients receiving services that either did not happen or were not necessary, so that the clinics could file claims with Blue Cross Blue Shield, according to prosecutors.

Fernandez Delmas was one of the true owners of at least 25 different health clinics in the Miami area. Licensed physical therapists were also recruited to lend credibility to the medical claims submitted and help the clinic owners avoid medical licensing requirements for their businesses, according to the DOJ.

Court records show that Fernandez Delmas received more than $880,000 in compensation from 11 of the clinics for her managerial role in operating the scheme.

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