Final Defendant Sentenced to Federal Prison in 12-Defendant, $53 Million Healthcare Fraud Conspiracy

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, followed by three years of supervised release, and ordered to pay a restitution in the amount of $547,560.00, 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, Fla., Alexander Juan, 47, of Miramar, Fla., Aymee Caballero, 52, of Miramar, Fla., Roberto Ballester-Ramos, 55, of Hialeah, Fla., Roberta Ascencion, 69, of Hialeah, Fla., Mara Ventura, 36, of Hialeah Gardens, Fla., Vladimir Perez Pena, 58, of Hialeah, Fla., Amado Plain Moreno, 36, of Miami, Fla., Carlos Sablon, 55, of Hialeah, Fla., Maria Rodriguez-Alvarez, 58, of Hialeah, Fla., 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 defendants opened multiple clinics throughout South Florida, and paid recruiters to provide personal information for BCBS beneficiaries. The defendants 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.

All defendants entered guilty pleas, and have been sentenced as follows: Jorge Caballero was sentenced to 52 months in prison, Alexander Juan was sentenced to 48 months in prison, Aymee Caballero was sentenced to 41 months in prison, Roberto Ballester Ramos was sentenced to 45 months in prison, Roberta Ascencion was sentenced to 12 months in prison, Mara Ventura was sentenced to 12 months in prison, Vladimir Perez Pena was sentenced to 11 months, Amado Plain Moreno was sentenced to 33 months in prison, Carlos Sablon was sentenced to 12 months in prison, and Maria Rodriguez Alvarez was sentenced to 4 months in prison. They all have agreed to pay more than $9,000,000 in restitution.

“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.”

“Individuals who steal from our health care system are not just stealing money from the government. Instead, they are stealing from the most vulnerable among us – the sick, the elderly, the poor,” said Justin E. Fleck, Deputy Special Agent in Charge, FBI Miami. “The FBI will not relent in our efforts to investigate and bring them to justice, and seize their illegal income and assets in restitution.”

U.S. Attorney Markenzy Lapointe for the Southern District of Florida 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.