Please note: As of January 20, 2021, information in some news releases may be out of date or not reflect current policies.
U.S. District Court Sentences Louisville Health Clinic Co-Founder to Prison and Orders Payment of $941,337 in Restitution for Healthcare Fraud Scheme
LOUISVILLE, KY – As a result of an investigation by the U.S. Department of Labor's Employee Benefits Security Administration (EBSA), the U.S. District Court for the Western District of Kentucky has sentenced David Perez - co-founder of a Louisville, Kentucky, medical clinic - to 27 months in prison, two years of supervised release, and to pay $941,337 restitution for defrauding healthcare benefit programs. Perez pleaded guilty in August 2018 to nine counts of healthcare fraud, nine counts of theft in connection with healthcare valued at $941,337, and one count of aggravated identity theft.
EBSA's investigation found Perez was involved in a fraudulent scheme to establish Healthy Life Center Inc. and bill Humana Insurance Co. and United Healthcare for patient injections that the clinic never administered. Both insurance companies billed private-sector employee welfare benefit plans for the false charges and the private-sector employee welfare benefit plans paid a portion of the false charges as a result.
Investigators also found Perez unlawfully used the identification of a medical provider on the billing statements, alleging the medical provider administered the false services to the patients. Fellow Healthy Life Center co-founder, Osmaro Ruiz will be tried at a later date.
"Knowingly committing healthcare fraud victimizes insurance companies and hardworking employees," said Employee Benefits Security Administration Regional Director L. Joe Rivers, in Cincinnati, Ohio. "Fraudulently inflating healthcare bills for unnecessary or non-existent treatments increases the cost for others in need of health insurance. The U.S. Department of Labor remains committed to ensuring that benefits are not abused, and anyone found guilty of committing fraud is held accountable."
Employers and workers can reach EBSA toll-free at 866-444-3272 for help with problems related to private sector retirement and health plans. Additional information can be found at http://www.dol.gov/ebsa.