Two Miami men were sentenced to prison time on Friday after using urine drug-testing to scam insurance companies, according to the U.S. Department of Justice.
In a release, DOJ officials said that the men — Jorge Perez, 63, and Ricardo Perez, 60 — would use hospitals to bill for testing that wasn’t reimbursable or medically necessary.
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Jorge Perez, an owner of hospitals and a billing company, teamed up with Ricardo Perez and others to target “financially distressed” rural hospitals in Missouri and Florida, sending them fraudulent bills, the release shows.
These bills took advantage of private insurance contracts that provided higher reimbursement rates for these hospitals than out-of-network labs, which is where the testing was done in most cases, investigators explained.
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The drug tests were for patients at pain clinics or those being treated for addiction, though the testing was performed far more often than was necessary as part of the scheme, according to the DOJ.
The hospitals involved in the case were as follows:
- Campbellton-Graceville Hospital - Graceville, FL
- Declared bankruptcy in 2017
- Regional General Hospital Williston - Williston, FL
- Closed
- Putnam County Memorial Hospital - Unionville, MO
- Has struggled since Jorge Perez and Ricardo Perez began using it as a vehicle for laboratory billing
Both men were convicted in June 2022 of conspiracy to commit health care fraud and wire fraud, five counts of health care fraud, and conspiracy to commit money laundering.
As a result, Jorge Perez was sentenced to eight years and four months in prison. Likewise, Ricardo Perez was sentenced to six years and three months in prison.
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