Two sentenced for health care fraud of Missouri, Florida hospitals

COLUMBIA, Mo. (KMIZ)

Two men from Florida were sentenced earlier this month for a multi-state scheme to defraud insurance companies, according to a press release from the Department of Justice.

The release states Jorge Perez, 63, and Ricardo Perez, 60 – both of Miami – were using rural hospitals to bill for urine drug testing that was not reimbursable or medically necessary.

Jorge Perez was sentenced to eight years and four months in federal prison, while Ricardo Perez to six year, three months. The sentencing hearing took place on Dec. 15.

The release states the men were found guilty -- on June 27, 2022 -- of conspiracy to commit health care fraud and wire fraud, five counts of health care fraud and conspiracy to commit money laundering.

One of the hospitals listed in the release included Putnam County Hospital in Unionville, as well as two hospitals in Florida.

Jorge Perez was described in the release as an owner and manager of hospitals, as well as the owner of a billing company. Ricardo Perez was described in the release as the manager of the billing company. The release states the pair “targeted and obtained control over financially distressed rural hospitals, and then used them for billing in order to take advantage of private insurance contracts that provided higher reimbursement rates for these hospitals than for out-of-network laboratories.”

The release states the claims were then submitted falsely to look like the hospitals did the lab testing, when testing was done by others.

The tests billed by Jorge Perez and Ricardo Perez were often not medically necessary, according to the release, and testing was performed at a frequency that “far exceeded what would be needed for patient care.”