Five Sentenced for Medicare, Medicaid, and Wire Fraud, Florida 2014

Five residents of Miami-Dade County and one resident of Nicaragua have been sentenced for their participation in a $25.2 million Medicare, Medicaid, and wire fraud scheme.

Erendira V. Delgado, a/k/a “Eren Delgado,” 31, of Miami, was sentenced to 40 months imprisonment. Edgardo Rodriguez, 47, of Nicaragua, was sentenced to 42 months imprisonment. Rodney Montoya, 36, of Miami, was sentenced to 48 months imprisonment. Deborah Smith, 53, of Hialeah, was sentenced to 15 months imprisonment. Augustin Abaga, 48, of Sunny Isles, was sentenced to 18 months imprisonment.

Each defendant was sentenced to serve a three year term of supervised release upon completion of their incarceration and pay restitution to the Centers for Medicare and Medicaid Services. The defendants were charged with conspiracy to commit health care fraud and wire fraud, substantive counts of health care fraud, conspiracy to defraud the United States and make false statements related to health care matters, and substantive counts of making false statements related to health care matters.

The scheme, which began in 2014, involved recruiting individuals who resided in Nicaragua and the Dominican Republic to enroll in Medicare Advantage plans and Florida Medicaid by falsely and fraudulently representing in enrollment applications that they resided in Florida. The defendants submitted false and fraudulent enrollment applications claiming that beneficiaries resided in Florida when, in fact, they resided in Nicaragua and the Dominican Republic.

The indictment also charged Pedro Hernandez, a/k/a “Peter Hernandez,” 51, of Miramar, Freddy Zeron, 52, of Miami and Nicaragua, Abram J. Rodriguez, a/k/a “Abe Rodriguez,” 31, of Miami, Santiago Bernabe Montoya, 72, of Miami, Jose Eloy Sanchez, a/k/a “Jose Eloy Sanchez Arguello,” 70, of Coral Gables and Nicaragua, and Mirna L Blanco, 49, of Hialeah, with conspiracy to commit health care fraud and wire fraud, substantive counts of health care fraud, conspiracy to defraud the United States and make false statements related to health care matters, and substantive counts of making false statements related to health care matters.

On October 30, 2014, a federal grand jury in Miami returned a 36-count indictment charging the defendants with their roles in the scheme. Beginning on November 19, 2014, ten of the eleven individuals charged in the indictment were arrested. Sanchez remains at large and is believed to be in Nicaragua.

Prior to their sentencing, several of the defendants had pleaded guilty to their roles in the scheme. Blanco was sentenced to 24 months imprisonment on May 5, 2015, after pleading guilty to conspiracy to commit wire fraud and health care fraud.

The scheme resulted in over $25.2 million in losses to Medicare and Medicaid. The defendants are required to pay restitution to the Centers for Medicare and Medicaid Services.

Source: https://www.justice.gov/usao-sdfl/pr/five-individuals-sentenced-their-role-medicare-and-medicaid-fraud-scheme-florida