Florida woman sentenced in $36M physical therapy fraud
A 33-year-old woman has been sentenced for her leading role in a $36 million healthcare fraud conspiracy. According to a release from the U.S. Attorney’s Office of the Department of Justice (DOJ) in the Southern District of Florida, she was one of 12 defendants who pleaded guilty for their role in a health insurance scheme that took place at 30 different physical therapy clinics from August 2018 to February 2023.
According to the DOJ, Arisleidys Fernandez Delmas of Florida billed Blue Cross Blue Shield for physical therapy services that patients never received. She pleaded guilty to conspiracy to commit healthcare fraud.
For her role in the scam, Fernandez Delmas will serve up to 104 months in prison, after which she is eligible for three years of supervised release. She is also ordered to pay $8,671,377 in restitution. According to the statement from the DOJ, she and her co-conspirators in the scheme paid kickbacks to beneficiaries of health insurance plans managed by Blue Cross Blue Shield. These incentive payments were offered to employees of JetBlue Airways, AT&T, and TJX to entice them to act as patients at the clinics.
The DOJ said those who owned the clinics would then submit unnecessary insurance claims for physical therapy service and health benefits "that were medically unnecessary and not even provided."
As part of the scam, the DOJ said the conspirators would also pay licensed massage therapists to act as care providers at the physical therapy clinics. The move allowed the co-conspirators to avoid having the proper medical licensing requirements, which the DOJ said was to help cover up their illegal actions.
The 11 co-defendants all pleaded guilty to conspiracy to commit healthcare fraud. They are awaiting sentencing.
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