9 arrested in Florida for allegedly orchestrating $37M scheme to defraud Blue Cross Blue Shield

Nine Florida residents were arrested for allegedly conspiring to bill $37 million in fraudulent claims to Blue Cross Blue Shield, the Justice Department said Dec. 6. 

The Justice Department alleged the nine defendants paid kickbacks to employees of JetBlue Airways, AT&T and TJX Companies, who were Blue Cross beneficiaries, to be patients at 30 South Florida physical therapy clinics the defendants owned. 

The defendants would then submit claims to Blue Cross for services not provided, the Justice Department alleged. 

The defendants also allegedly paid kickbacks and bribes to each other for referring additional patients to their clinics. The Justice Department said the defendants also allegedly paid licensed massage therapists to serve as nominee owners of the clinics to avoid licensing requirements. 

The licensed massage therapists were also arrested, the Justice Department said. 

The nine defendants have been charged with multiple counts of conspiracy to commit healthcare fraud and healthcare fraud. If convicted, each defendant faces up to 10 years in prison per count.

Becker's reached out to the Justice Department for further clarification on which BCBS affiliate is being referenced in the news release. A spokesperson said "Blue Cross Blue Shield" is the only name available in public records for the case.

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Whitepapers

Featured Webinars