On December 26, 2024, the last of ten fraudsters involved in a $53 million Medicare scheme was sentenced to prison. Jose Goyos, joins his co-conspirators, for his part as the leader of the call centers which conducted deceptive telemarketing campaigns to fool doctors into signing fraudulent durable medical equipment or genetic testing orders for Medicare beneficiaries. Dupe the doctor!
Goyos ran what was called the “doctor chase” part of the call centers used in this scheme. Primary care physicians of targeted Medicare beneficiaries were contacted and tricked into ordering medically unnecessary tests. Goyos actually wrote a “doctor chase manual” for the call center. It included the lies to be told by his telemarketing staff. For example, Goyos directed 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. Scripts were provided to trick the doctors into signing the orders!
To further deceive the doctors, Goyos also created a website for a front company, Gentec Solutions, to provide medical providers a false sense of security that they were dealing with a legitimate medical provider as opposed to a call center. Doctors were misled to believe that “Gentec” treated the patients.
Goyos’ co-conspirators then used those doctors’ orders to submit over $67 million claims to Medicare for expensive and medically unnecessary genetic tests.
Shout out to the Health and Human Services Office Inspector General in this case.
Today’s Fraud of The Day is based on article “How a $53 million fraud got a Florida telemarketer and his 9 cronies prison time” published by The Miami Herald on December 16, 2024.
Ten people from Broward and Palm Beach counties used three call centers and three laboratories to fool doctors and rip off $53 million from Medicare. And, now, all 10 reside in the federal prison system. West Palm Beach’s Jose Goyos became the last of the economic gang to be sentenced to prison in December, getting 15 years on attempt and conspiracy to commit mail fraud and money laundering. Goyos will serve those sentences, the group’s second longest, concurrently.
Daniel M. Carver, 38, of Boca Raton got the longest sentence of the group, 16 years and eight months, after pleading guilty to attempt and conspiracy to commit mail fraud and conspiracy to defraud the United States. Carver owned the call centers and Medicare-enrolled clinical labs used in the scam.