Florida man charged in $38M UnitedHealth, BCBS false claims scheme

A Miami man was arrested Dec. 10 and charged with submitting approximately $38 million in fraudulent healthcare claims to Blue Cross Blue Shield and UnitedHealthcare, according to the Justice Department. 

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Armando Valdes, the owner and operator of a medical clinic in Miami, allegedly submitted false claims to the insurance companies for infusions of infliximab, known by the brand name Remicade, which were medically unnecessary and not provided to patients as billed. The drug is used to treat several diseases, including Crohn’s disease and ulcerative colitis. 

Mr. Valdes used nearly $8 million in proceeds from the alleged scheme to buy real estate and luxury vehicles, the indictment alleges. 

Mr. Valdes is charged with 10 counts of healthcare fraud and faces up to 100 years in prison if convicted, according to the Justice Department.

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