A South Florida-based insurance brokerage company has pleaded guilty to its role in a massive Affordable Care Act (ACA) enrollment fraud scheme. AP of South Florida, LLC (APSF) targeted thousands of vulnerable consumers, including those experiencing homelessness, unemployment, and mental health issues, and induced them to enroll in fully subsidized ACA plans with cash and gift cards.
According to court documents, APSF’s highest-ranking executives knowingly and intentionally defrauded the federal government by submitting false and fraudulent applications for individuals whose income did not meet the minimum requirements to be eligible for the subsidies. As a result, the federal government awarded $141.5 million in unwarranted subsidies.
The scheme, which was uncovered by the Department of Justice, resulted in APSF agreeing to pay $27.6 million in restitution as part of its plea agreement. The company also admitted to its wrongdoing, acknowledging that it preyed on vulnerable consumers to enrich itself.
The Department of Justice, working closely with President Trump’s Task Force to Eliminate Fraud, has been cracking down on healthcare scams. Acting Attorney General Todd Blanche praised the efforts, saying, “Thanks to the leadership of President Donald Trump, the Department is supercharging efforts to take down every fraudster and bring them to justice.”
In a parallel civil resolution, AssuredPartners, Inc., the parent company of APSF, agreed to pay $107 million to resolve allegations that it violated the False Claims Act by submitting fraudulent ACA health insurance plan applications.
The case is a stark reminder of the ongoing threat of healthcare scams and the importance of vigilance in protecting vulnerable consumers. As the Department of Justice continues to pursue those responsible for these crimes, one thing is clear: those who rip off the American people will be held accountable.
Source: Department of Justice
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