$67M health care fraud scheme ends in 15-year sentence for Florida man

FLORIDA — A Florida telemarketer has been sentenced to 15 years in prison for orchestrating a wide-reaching Medicare fraud and money laundering scheme that cost taxpayers over $67 million.

Jose Goyos, 38, of West Palm Beach, reportedly played a central role in a call center operation that targeted thousands of Medicare beneficiaries and their physicians. Prosecutors described how Goyos led the “doctor chase” division, instructing employees to mislead primary care physicians into approving unnecessary genetic testing.

The operation involved fabricating medical paperwork and falsely claiming that Medicare beneficiaries were “mutual patients” who had requested the tests. In many cases, Mr Goyos and his team fabricated medical conditions to justify the expensive tests, according to court documents.

Between May 2020 and July 2021, Goyos and his co-conspirators submitted more than $67 million in fraudulent Medicare claims, resulting in payouts exceeding $53 million.

Prosecutors noted that the genetic test results were often never shared with the beneficiaries’ physicians or used in their treatment.

In October 2023, a jury convicted Mr Goyos of conspiracy to commit wire fraud and conspiracy to commit money laundering.

Nine other Florida residents were previously sentenced for their involvement in the scheme. Among them, Daniel M. Carver, 38, of Boca Raton, received the harshest penalty at nearly 17 years in prison.

Others included Thomas Dougherty of Palm Beach and John Paul Gosney Jr. of Parkland, who were sentenced to 14 years and nearly eight years, respectively.

U.S. Attorney Markenzy Lapointe of the Southern District of Florida, along with federal agencies, announced the sentencing. The FBI and the Department of Health and Human Services Office of the Inspector General conducted the investigation.

Assistant U.S. Attorneys Sara Klco, Marx Calderon, and Sandra Dermici oversaw asset forfeiture proceedings, while trial attorneys Reginald Cuyler Jr. and Andrew Tamayo prosecuted the case.

Federal authorities emphasized their commitment to targeting fraudulent schemes that exploit Medicare, stating that such actions undermine the integrity of the healthcare system and waste taxpayer funds.