7 Miami people who tried a $17 million healthcare fraud are in prison. One is on the run

A $5 million healthcare scam run of medical clinics in Miramar and West Miami-Dade ended last week with a 21-year-old office employee sentenced to restitution and prosecutors trying to find the man who got the longest prison sentence.

Between those extremes, seven people are doing federal prison time and one other person has been slapped with restitution for a healthcare fraud that tried to get $17.9 million out of Blue Cross Blue Shield with fraudulent claims. They wound up getting about $4.8 million. Each person pleaded guilty to one count of conspiracy to commit healthcare fraud.

The disappeared fraudster, Jorge Gonzalez Perez, hasn’t been seen since before the Jan. 4 sentencing hearing for which he didn’t appear. The online docket entry that accompanied Perez’s Jan. 20 sentencing includes the line, “The government stated that it was possible the defendant had fled to Mexico.”

Wherever Perez is, it’s not in federal prison starting his sentence of 10 years and $4,143,892 in restitution. By not appearing, both his bonds are forfeited, the $75,000 bond for which Perez put up $7,500, and the $150,000 bond guaranteed by his wife, mother and a friend.

Life Blue, Blue Life and the ripoff of Blue Cross Blue Shield

Perez, 57, was the owner of Life Blue Medical Center, 12260 SW Eighth St., in West Miami-Dade and Blue Life Medical Center, 6272 Miramar Pkwy., in Miramar. Miami Medical Therapy and Research Center, 10380 W. Flagler St., was owned by David Sacerio, 30, and Kiamy Perez, 36.

The healthcare scheme included 66-year-old Dr. Orlando Leiva. He worked at Life Blue and Miami Medical.

Patient recruiters steered or brought patients to these clinics. Perez’s admission of facts says the clinics “primarily submitted claims for therapy procedures, including electrical stimulation, ultrasound therapy and therapeutic exercises, as well as allergy tests and durable medical equipment.”

Were these necessary? Leiva signed off on them. But as court documents filed by Leiva’s attorney stated, he saw patients for their first visit, but didn’t do follow-ups.

“Approximately seven to ten days after the initial consultation, he would go to the clinic and sign charts for follow-up consultations without seeing the patients,” the description of Leiva’s role stated. “The charts were left on a desk for him and he would sign them without asking questions. Dr. Leiva requested payment of $250 to $300 per patient. He falsified medical records and signed documentation falsely indicating that (Blue Cross Blue Shield) beneficiaries had received physical therapy services, treatment and follow-up treatment,when in fact, they had not.”

This documentation would be used for the phony claims.

Also sentenced, in addition to Jorge Gonzalez Perez, for this scheme are:

▪ Leiva, sentenced to four years, nine months in prison, three years supervised release and $2,867,770 in restitution;

▪ Sacerio, sentenced to four years, three months in prison, three years supervised release, and $686,086 in restitution;

▪ Kiamy Perez, sentenced to two years, 10 months in prison, three years supervised release, and $686,086 in restitution;

▪ Patient recruiter Enry Guzman, 43, sentenced to two years, nine months in prison, three years supervised release, and $228,075 in restitution;

▪ Physical therapy assistant Kyrenia Maqueira Rodriguez, 40, sentenced to two years, six months in prison, three years supervised release, and $686,086 in restitution;

▪ Patient recruiter Freymil Lozada, 34, sentenced to two years, three months in prison, three years supervised release, and $184,393.52 in restitution;

▪ Patient recruiter Haniel Rodriguez, 45, was sentenced to two years in prison, three years supervised release, and $198,540.57 in restitution;

▪ Patient recruiter Brian McIntosh, 53, got sentenced to $119,174.66 in restitution;

▪ Miami Medical office worker and last person sentenced, Melissa Cruz, 21, got sentenced to $686,086.33 in restitution.