FEDS: Miami Resident Charged with Committing $38 Million Health Care Fraud Scheme; Proceeds Spent on Beachfront Condos, Luxury Vehicles

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According to allegations in the federal grand jury indictment, the 63-year-old owner of a medical clinic in Miami, Florida, submitted approximately $38 million in false and fraudulent claims to United and Blue Cross for infusions of Infliximab which were medically unnecessary and not provided to patients as billed. File photo: Ken Wolter, Shutter Stock, licensed.

MIAMI, FL – A Miami man charged with submitting approximately $38 million in fraudulent health care claims to United Healthcare and Blue Cross Blue Shield was arrested on Friday morning, December 10, 2021, by federal law enforcement agents.

According to allegations in the federal grand jury indictment, from February 2015 through July 2021, 63-year-old Armando Valdes owned and operated Gasiel Medical Services, Corp. (“Gasiel”) a medical clinic in Miami, Florida. It is alleged that Gasiel submitted approximately $38 million in false and fraudulent claims to United and Blue Cross for infusions of Infliximab which were medically unnecessary and not provided to patients as billed.

Infliximab, known by the brand name Remicade, is an expensive prescription immunosuppressive drug approved for the treatment of Crohn’s disease, pediatric Crohn’s disease, ulcerative colitis, pediatric ulcerative colitis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and plaque psoriasis. The indictment alleges that United and Blue Cross paid Gasiel nearly $8 million as a result of the fraudulent claims for Infliximab submitted by Valdes. According to the indictment, Valdes used his ill-gotten proceeds to purchase four real estate properties, including a beachfront condo in Pompano Beach, as well as luxury vehicles including a Cadillac Escalade and a Tesla Model S.

The indictment charges Valdes with ten counts of health care fraud. If convicted, Valdes faces up to 100 years in prison.  A federal district judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.

Valdes was scheduled to make his initial appearance Friday at 1:30 p.m., before U.S. Magistrate Judge Jacqueline Becerra, in Miami. Juan Antonio Gonzalez, U.S. Attorney for the Southern District of Florida, and George L. Piro, Special Agent in Charge, FBI, Miami Field Office announced the charges.  Assistant U.S. Attorney Michael B. Homer is prosecuting this case.  Assistant U.S. Attorney Annika Miranda is handling asset forfeiture.

An indictment is a charging instrument containing allegations.  A defendant is presumed innocent unless and until proven guilty in a court of law.

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