12 sentenced following guilty pleas in $53 million health care fraud conspiracy

FLORIDA – The last of 12 defendants has been sentenced for his role in a $53 million health care fraud conspiracy, the U.S. Attorney’s Office for the Southern District of Florida (USAO) has announced.

According to the USAO, Edgar Perez, 51, of Miramar, Florida, the final defendant in a 12-defendant health care fraud conspiracy, was sentenced to 12 months in federal prison last week, followed by three years of supervised release.

Also, he was ordered to pay restitution in the amount of $547,560 for his participation in a health care fraud conspiracy that billed Blue Cross Blue Shield (“BCBS”) for more than $53 million for services, including allergy tests and physical therapy, that patients never received.

Jorge Caballero, 44, of Hialeah, Alexander Juan, 47, of Miramar, Aymee Caballero, 52, of Miramar, Roberto Ballester-Ramos, 55, of Hialeah, Roberta Ascencion, 69, of Hialeah, Mara Ventura, 36, of Hialeah Gardens, Vladimir Perez Pena, 58, of Hialeah, Amado Plain Moreno, 36, of Miami, Carlos Sablon, 55, of Hialeah, Maria Rodriguez-Alvarez, 58, of Hialeah, and Edgar Perez were indicted on July 28, 2022, and charged with conspiracy to commit health care fraud and wire fraud, and health care fraud, the USAO said.

According to the USAO, the defendants opened multiple clinics throughout South Florida and paid recruiters to provide personal information for BCBS beneficiaries. The defendants reportedly then submitted fraudulent bills to BCBS and received payments into clinic bank accounts before transferring to personal accounts, making cash withdrawals, and laundering money through various businesses and individuals.

The USAO said all of the defendants entered guilty pleas and have been sentenced as follows:

• Jorge Caballero, sentenced to 52 months
• Alexander Juan, sentenced to 48 months
• Aymee Caballero, sentenced to 41 months
• Roberto Ballester Ramos, sentenced to 45 months
• Roberta Ascencion, sentenced to 12 months
• Mara Ventura, sentenced to 12 months
• Vladimir Perez Pena, sentenced to 11 months
• Amado Plain Moreno, sentenced to 33 months
• Carlos Sablon, sentenced to 12 months
• Maria Rodriguez Alvarez, sentenced to 4 months

Each has agreed to pay more than $9,000,000 in restitution, the USAO said.

“These defendants compromised the integrity of America’s healthcare system by stealing millions of dollars that should have gone to providing quality care to patients with true medical needs,” said U.S. Attorney Markenzy Lapointe for the Southern District of Florida.

“Such criminal behavior will not be tolerated in this district.”

Lapointe and Special Agent in Charge Jeffrey B. Veltri of the FBI, Miami Field Office, made the announcement.

FBI Miami investigated the case. Assistant U.S. Attorney Lindsey Lazopoulos Friedman prosecuted it. Assistant U.S. Attorney Joshua Paster is handling asset forfeiture.

Related court documents and information may be found on the website of the District Court for the Southern District of Florida at www.flsd.uscourts.gov or at http://pacer.flsd.uscourts.gov under case number 22-cr-20341.