Florida man convicted after Medicare faced millions in false testing claims.
A Florida man who helped run a medical testing company and a separate marketing business has been found guilty of taking part in a Medicare fraud scheme involving COVID-19 testing. Federal prosecutors said Joseph Rodriguez used testing events at residential country clubs to arrange blood tests that many patients did not request, did not need, and had not been ordered by a doctor. Medicare was billed more than $15 million for the tests.
A federal jury in the Southern District of Florida convicted Rodriguez, 58, of Coral Springs, on one count of conspiracy to commit health care fraud and six counts of health care fraud. He faces up to 10 years in prison on each count. A sentencing date is expected to be set for January 2027. The final sentence will be decided by a federal judge after a review of sentencing rules and other factors. The case involved COVID testing events held at nine residential country clubs in the West Palm Beach area during the pandemic. Rodriguez was a vice president of a testing laboratory and also owned and operated Phoenix Health, a marketing company. According to evidence presented in court, Phoenix Health helped arrange the testing events at the clubs.
Patients who signed up were expecting COVID-19 nasal swab tests and blood antibody tests. Prosecutors said many were then asked to give additional blood samples. Those samples were used for a wide range of other tests, including hormone testing and tests for heavy metals such as arsenic, mercury, and cadmium. The patients had not asked for those tests, and the tests had not been ordered by their doctors.
The government said Rodriguez directed workers to collect the extra blood and then caused claims to be sent to Medicare saying that the tests were medically needed and had been ordered by a treating doctor. A doctor’s name was also placed on the claims without the doctor’s knowledge or approval, according to evidence presented at trial. The scheme involved almost 2,000 patients over about four months. Medicare received claims totaling more than $15 million and paid more than $500,000, according to the Department of Justice.
Some of the evidence came from complaints raised during the testing events. Patients contacted Rodriguez after discovering that additional blood work had been done. A doctor whose name appeared on some of the Medicare claims also questioned why thousands of dollars in blood tests had been billed under that doctor’s name. Managers at several residential clubs questioned why members were having extra blood drawn when they had signed up only for COVID-19 testing. Federal officials said the case was especially troubling because the testing took place during the COVID-19 pandemic, when many older adults were seeking testing because of concerns about their health. Officials said the patients trusted the people providing the testing and expected to receive only the services they had requested.
The FBI and the U.S. Department of Health and Human Services Office of Inspector General investigated the case. Federal prosecutors from the DOJ’s Health Care Fraud Section handled the trial. The agency said its health care fraud efforts have resulted in charges against more than 6,200 defendants since 2007. Those cases involved claims totaling more than $45 billion against federal health programs and private insurers.
This case is a prime example of the fact that health care fraud can involve more than false billing alone. Patients can also be affected when medical services are performed without their knowledge or when health information is used to support claims that do not match the care actually provided. The case will now move to the sentencing stage.
Sources:
Florida Man Convicted of Billing Medicare $15 Million for Blood Tests Patients Never Wanted
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