MIAMI MAN SENTENCED IN FEDERAL COURT FOR
MEDICAL IDENTITY THEFT SCHEME
Rural Gainesboro, Tennessee Barn Used as Medical Provider Address
Yennier Capote Gonzalez, 33, of Miami, Florida, was sentenced on February 15, 2013, by Chief U.S. District Judge William J. Haynes, Jr., to serve 67 months in federal prison, and ordered to pay restitution in the amount of $19,296 for his role in a medical identity theft scheme, announced Jerry E. Martin, U.S. Attorney for the Middle District of Tennessee.
Gonzalez was convicted by a federal jury in Nashville, Tennessee on November 2, 2012, of five counts of health care fraud, two counts of aggravated identity theft and one count of money laundering, after he falsely billed $232,000 to Medicare Advantage Program insurance companies.
“Health care fraud and identity theft are top priorities of the U.S. Attorney’s Office,” said U.S. Attorney, Jerry E. Martin. “We continue to expand our focus and dedicate new resources to investigating and prosecuting this type of white collar criminal activity and will stay the course to insure that those who operate fraudulent schemes such as this are held accountable.”
“Medical identity theft is one of the fastest growing areas of health care fraud,” said Derrick L. Jackson, Special Agent in Charge of the U.S. Department of Health and Human Services- Office of Inspector General in Atlanta. “In this case, the defendant was arrested less than 48 hours after our office received the complaint. The sentence handed down today should serve as a deterrent to anyone who tries to defraud the Medicare program.”
This investigation began in August 2010 after the U.S. Department of Health and Human Services- Office of Inspector General was notified that an individual in Miami, Fla. had attempted to wire $17,000 from a new Tennessee account that had recently received a $38,000 Medicare deposit. Gonzalez had opened the account for his recently incorporated business, Gainesboro Ultimate Med Service, in rural Gainesboro, Tennessee. A visit to the property revealed the only structure at the business location was an old barn and an uncompleted house at another tract of land that was used as the address for the fraudulently billed patients.
The investigation also revealed that Gainesboro Ultimate Med Service had stolen the identity of a Knoxville, Tennessee physician and used it to obtain a Medicare provider number at the barn address. Gainesboro Ultimate Med Service then submitted claims using the names of several Medicare beneficiaries who lived in South Florida. The patients, who were also victims of identity theft, were billed for services purportedly rendered at Gainesboro Ultimate Med Service, even though they had never been to Tennessee.
Gonzalez was arrested on August 25, 2010, at a bank in Miami, Fla., during another wire transfer attempt.
This case was investigated by agents of the U.S. Department of health & Human Services-Office of Inspector General. The government is represented by Assistant U.S. Attorneys Darryl Stewart and William Abely.
Stop Medicare Fraud
The U.S. Department of Health and Human Services (HHS) and U.S. Department of Justice (DOJ) are working together to help eliminate fraud and investigate fraudulent Medicare and Medicaid operators who are cheating the system.