Two Miami men were sentenced for a multistate scheme that used rural hospitals to bill for medically unnecessary urine drug testing.
Jorge Perez, 63, the owner and manager of hospitals and the owner of a billing company, and Ricardo Perez, 60, the manager of a billing company, conspired to unlawfully bill for lab testing service in rural hospitals in Missouri and Florida, rather than the laboratories where the testing took place, according to a Dec. 15 news release from the Justice Department.
The pair targeted and obtained control over hospitals in financial distress and then fraudulently billed private insurers, which provided higher reimbursements for the hospitals than the laboratories. The claims were submitted to appear that the hospitals did the testing when in most cases it was done by testing laboratories.
Additionally, according to the report, the fraudulent testing was for vulnerable addiction treatment patients with samples often obtained through kickbacks.
The hospitals involved were Graceville, Fla.-based Campbellton-Graceville Hospital, which declared bankruptcy in 2017, the now-shuttered, Williston, Fla.-based Regional General Hospital Williston and Unionville, Mo.-based Putnam County Memorial Hospital.
Jorge Perez was sentenced to eight years and four months in prison, and Ricardo Perez was sentenced to six years and three months in prison.