A Florida man has been sentenced to 15 years in prison for his involvement in a conspiracy to defraud Medicare by billing over $67 million for unnecessary genetic testing. According to court documents, Jose Goyos, 38, from West Palm Beach, worked at a call center that made deceptive telemarketing calls targeting Medicare beneficiaries and their physicians.
Goyos managed the "doctor chase" division of the call center, which involved contacting primary care physicians of targeted Medicare beneficiaries. The call center tricked these medical providers into ordering unnecessary genetic tests based on fabricated medical paperwork. Goyos directed employees to falsely claim that the Medicare beneficiaries were "mutual patients" who requested these tests and had conditions justifying them.
Using doctors' orders obtained through deception, Goyos and his co-conspirators submitted claims to Medicare for expensive and medically unnecessary genetic tests. These test results were often not sent to the beneficiaries' primary care physicians or used in their treatment.
Between May 2020 and July 2021, over $67 million in false claims were submitted to Medicare, with more than $53 million paid out. In October 2023, a jury convicted Goyos of conspiracy to commit wire fraud and money laundering.
Nine other Florida residents have been sentenced for their roles in the scheme:
- Daniel M. Carver, 38, received 16 years and eight months.
- Thomas Dougherty, 42, was sentenced to 14 years.
- John Paul Gosney Jr., 42, got seven years and eleven months.
- Galina Rozenberg, 42, received four years.
- Michael Rozenberg, 61, also received four years.
- Ethan Macier, 25, was sentenced to three years and nine months.
- Louis “Gino” Carver, 33, got two years and eight months.
- Ashley Cigarroa, 32, received two years and six months.
- Timothy Richardson, 31, was sentenced to two years.
The announcement was made by U.S. Attorney Markenzy Lapointe for the Southern District of Florida; Principal Deputy Assistant Attorney General Nicole M. Argentieri; Special Agent in Charge Jeffrey B. Veltri of the FBI Miami Field Office; and Special Agent in Charge Stephen Mahmood of HHS-OIG Miami Regional Office.
The case was investigated by the FBI and HHS-OIG. Assistant U.S. Attorneys Sara Klco, Marx Calderon, Sandra Dermici handled asset forfeiture while Trial Attorneys Reginald Cuyler Jr., Andrew Tamayo along with former Trial Attorney Patrick J. Queenan prosecuted the case.
The Fraud Section leads efforts against health care fraud through the Health Care Fraud Strike Force Program which has charged over 5,400 defendants since March 2007 who collectively billed more than $27 billion from federal health care programs.