Daily Flux Report

West Palm Beach man sentenced to 15 years for $67M Medicare fraud and laundering scheme

By Gershon Harrell

West Palm Beach man sentenced to 15 years for $67M Medicare fraud and laundering scheme

WEST PALM BEACH, Fla. (CBS12) -- A West Palm Beach Man was sentenced to 15 years in prison for conducting a $67 million health care fraud and money laundering scheme.

According to court documents from the United States Department of Justice (DOJ), Jose Goyos of West Palm Beach was employed at a call center that engaged in deceptive telemarketing calls that targeted thousands of Medicare beneficiaries and their physicians.

The DOJ says Goyo, 38, managed the so called "doctor chase" division of the call center, which contacted the primary care physicians of targeted Medicare beneficiaries and tricked medical care providers into ordering medically unnecessary genetic tests based on medical paperwork that the call center created.

See also: Colorado dentist arrested at PBIA for soliciting sex from 8-year-old: DOJ

An example the DOJ gave was Goyos would direct his call center employees to falsely represent to providers "that the Medicare beneficiaries were 'mutual patients' who had requested these genetic tests and that the beneficiaries had medical conditions justifying genetic testing, when neither statement was true."

The DOJ says Goyos and his co-conspirators would use doctors' orders to submit claims to Medicare for expensive and medically unnecessary genetic tests. The DOJ says the results of the tests were often not sent to the Medicare beneficiaries' primary care physicians and were not used in the treatment of the beneficiaries.

From May of 2020 to July 2021, Goyos and his co-conspirators submitted $67 million in false and fraudulent claims to Medicare.

In October of 2023 jury convicted Goyos of conspiracy to conduct wire fraud and conspiracy to commit money laundering.

Nine additional Floridians were sentenced, as provided by the DOJ:

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