A Florida man has been jailed for 15 years for a huge Medicare fraud that billed $67 million for unnecessary genetic tests.
Jose Goyos, 38, of West Palm Beach, carried out a scheme exploiting vulnerable Medicare beneficiaries through deceptive telemarketing tactics and falsified medical orders.
The Fraudulent Scheme
According to court documents and evidence presented at trial, Goyos operated a “doctor chase” division within a call center that targeted Medicare beneficiaries and manipulated their physicians.
Employees under Goyos falsely claimed patients requested genetic tests and had medical conditions warranting such procedures.
Using these false claims, the group submitted fraudulent Medicare claims for costly genetic testing.
Test results were rarely shared with primary care physicians or used in patient treatment.
Between May 2020 and July 2021, Goyos and his co-conspirators submitted over $67 million in fraudulent claims, with Medicare disbursing more than $53 million.
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Sentences for Co-Conspirators
Goyos’s conviction follows the sentencing of nine other Florida residents involved in the conspiracy:
- Daniel M. Carver (Boca Raton): 16 years, 8 months.
- Thomas Dougherty (Palm Beach): 14 years.
- John Paul Gosney Jr. (Parkland): 7 years, 11 months.
- Galina Rozenberg (Hollywood): 4 years.
- Michael Rozenberg (Hollywood): 4 years.
- Ethan Macier (Boynton Beach): 3 years, 9 months.
- Louis “Gino” Carver (Boca Raton): 2 years, 8 months.
- Ashley Cigarroa (North Lauderdale): 2 years, 6 months.
- Timothy Richardson (Lantana): 2 years.
Investigation and Prosecution
The case was investigated by the FBI and the Department of Health and Human Services Office of the Inspector General (HHS-OIG). It was prosecuted by Trial Attorneys Reginald Cuyler Jr., Andrew Tamayo, and Patrick J. Queenan, with assistance from U.S. Attorneys Sara Klco, Marx Calderon, and Sandra Dermici.
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Health Care Fraud Strike Force
The Health Care Fraud Strike Force, operating in 27 federal districts, has charged over 5,400 defendants since its inception in 2007. Together, these defendants have been accused of defrauding federal healthcare programs and private insurers of more than $27 billion.
Broader Implications
The sentencing of Goyos and his co-conspirators in Florida is a reminder of the ongoing threat of healthcare fraud. The collaboration between federal agencies highlights the importance of safeguarding Medicare and holding fraudsters accountable.
For more information about combating healthcare fraud, visit the Justice Department’s Fraud Section.
