Physician Assistant who Pretended to be a Licensed Physician Pleads Guilty to Making False Statements to an Agency of the United States

SAN JUAN, Puerto Rico – Raúl D. Villalobos-Meléndez pleaded guilty today to making false statements and representations to an agency of the United States in violation of 18 U.S.C. § 1001(a)(2).

According to the Information, Raúl D. Villalobos-Meléndez, 36, of San Juan, knowingly falsified and forged documents and made materially false statements to the Centers for Medicare & Medicaid Services (CMS) representing himself to be a licensed physician. CMS is a federal agency within the United States Department of Health and Human Services that administers the Medicare and Medicaid program.

In truth, Raúl D. Villalobos-Meléndez has never been licensed to practice medicine in Puerto Rico or any part of the United States. 

Although Villalobos-Meléndez graduated as a Doctor of Medicine from the University of Science Arts and Technology-Monserrat College of Medicine on June 16, 2018, he never successfully passed the required United States Medical License Examination (USMLE). Instead, Villalobos-Meléndez obtained a Physician Assistant license in Puerto Rico on April 7, 2021, which permitted him to serve only as a physician assistant. The defendant then altered his Physician Assistant license documents to fraudulently submit them as a Provisional Medical License and a Permanent Medical License.

In 2023, Villalobos-Meléndez submitted a fraudulent application for a position in the Post-Graduate Medical Education Internship Program at Hospital del Maestro in San Juan, PR. As part of the documentation submitted with his application to the Hospital del Maestro, the defendant included a forged Provisional License Registry Certification, allegedly issued by the Puerto Rico Medical Discipline and Licensing Board (in Spanish, Junta de Licenciamiento y Disciplina Médica de Puerto Rico, abbreviated “JLDM”) and forged USMLE score reports falsely indicating that he had passed all three Steps.  In truth, Villalobos-Meléndez had failed the USMLE on multiple occasions and did not possess a Provisional Medical License.

Despite having no license to practice medicine in Puerto Rico, Raúl D. Villalobos-Meléndez received a salary to practice as a physician in the Transitional Internship program at the Hospital del Maestro in San Juan, Puerto Rico from June 1, 2023 to May 31, 2024.

On September 27, 2024, Villalobos-Meléndez knowingly submitted false information on a CMS-855I form to CMS when requesting enrollment as a physician practitioner and to become a Medicare provider. The defendant knowingly and fraudulently listed as active license information the false Puerto Rico medical license number “166037,” with an effective date of August 30, 2024, and designated his specialty as “General Practitioner.” Moreover, the defendant reassigned his benefits to the organization/group named Physician HMO. The president for Physician HMO signed, under penalty of perjury, accepting the reassignment of Medicare benefits for the defendant.

“The defendant lied to Puerto Rican and federal agencies by falsifying his documents and pretending to be a certified physician. This poses a danger to those who seek health care from medical professionals,” said W. Stephen Muldrow, United States Attorney for the District of Puerto Rico. “Along with our law enforcement partners, we will continue to investigate and prosecute these types of fraud that put the health and safety of health care patients at risk.”

“This case underscores our commitment to protecting the integrity of our health care system and patient safety. Using a forged medical license and providing false statements to gain access to federal healthcare programs is a serious breach of public trust,” stated Special Agent in Charge Naomi Gruchacz with the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG). “HHS-OIG and our law enforcement partners will continue to work relentlessly to ensure those who deceive the system will face justice.”

“Falsifying medical credentials to infiltrate America’s healthcare systems is not only fraud—it places lives at risk, erodes public trust, and undermines the integrity of the noble medical profession,” said Devin J. Kowalski, Special Agent in Charge of the FBI's San Juan Field Office. “The FBI remains committed to protecting the integrity of our systems and holding accountable those who exploit it for personal gain. We will continue working closely with our partners to investigate and bring to justice individuals who threaten the wellbeing of our communities.”

Villalobos-Meléndez made his initial court appearance today at the U.S. District Court for the District of Puerto Rico where he waived indictment and pleaded guilty to a one-count Information before United States District Judge Silvia Carreño-Coll.  He faces a maximum penalty of five years in prison, a fine not to exceed $250,000, and a term of supervised release. A federal district court judge will determine his sentence after considering the U.S. Sentencing Guidelines and other statutory factors.  The sentencing hearing has been scheduled for October 22, 2025, at 9:30 a.m.

The U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) and the Federal Bureau of Investigation (FBI) are investigating the case as part of Caribbean HEAT – a Healthcare Enforcement and Accountability Task Force & Working Group formed in 2024 to investigate and prosecute violations of federal law related to health care fraud, harm to patients and consumers, and health care program waste, fraud, and abuse. The Drug Enforcement Administration, the Puerto Rico Medicaid Fraud Control Unit and the U.S. Marshals also collaborated during the investigation. Special Assistant U.S. Attorney Wallace A. Bustelo from HHS-OIG is prosecuting the case.

To report fraud, waste or abuse related to health care matters, please contact HHS-OIG Hotline:

1-800-HHS-TIPS (1-800-447-8477) or https://tips.oig.hhs.gov

To file a voluntary self-disclosure related to health care matters, please access the link below:

https://oig.hhs.gov/compliance/self-disclosure-info/self-disclosure-protocol/

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