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National Insurance Brokerage Firm Pleads Guilty to Affordable Care Act Enrollment Fraud Scheme
AP of South Florida, LLC, a national partnership of insurance brokers, has agreed to plead guilty to its role in an Affordable Care Act enrollment fraud scheme, the U.S. Department of Justice announced.
The company, headquartered in Florida, preyed on thousands of vulnerable consumers to fraudulently enroll them into fully subsidized Affordable Care Act plans, for which the federal government awarded $141.5 million in unwarranted subsidies.
According to the plea agreement, AP of South Florida, LLC, through its highest-ranking executives, engaged in a scheme to defraud the federal government by submitting false and fraudulent claims for subsidies under the Affordable Care Act.
The scheme, which lasted from 2015 to 2022, resulted in the company receiving $141.5 million in unwarranted subsidies, which it used to pay for healthcare premiums and other expenses.
Under the terms of the plea agreement, AP of South Florida, LLC, has agreed to pay $135 million in restitution to the federal government and to cooperate fully with the government’s ongoing investigation into the scheme.
The company’s executives, who were not named in the plea agreement, will face significant penalties, including the possibility of prison time and fines.
The Affordable Care Act enrollment fraud scheme is a serious crime that has devastating consequences for those affected by it. The fact that AP of South Florida, LLC, was able to carry out this scheme for so long is a stark reminder of the need for greater oversight and regulation of the insurance industry.
Key Facts
- State: Colorado
- Agency: DOJ USAO
- Category: White Collar Crime|Fraud & Financial Crimes
- Source: Official Source â†â€â€ÂÂ
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