“Profit from human suffering”: Florida, Texas health care fraud duo gets slammed with hefty prison sentence for $180 million federal scam
Florida – Two executives tied to a sweeping health care fraud operation have been sentenced to lengthy prison terms after a federal jury found them responsible for orchestrating a years-long scheme that exploited vulnerable Americans and drained hundreds of millions of dollars from a taxpayer-funded insurance program.
Prosecutors said the president of an insurance brokerage firm and the chief executive of a marketing company targeted tens of thousands of low-income individuals, including people facing homelessness, addiction, and mental health challenges.
Through deceptive tactics and the use of street-level marketers, the pair pushed consumers into fully subsidized Affordable Care Act plans for which they did not qualify, allowing the defendants to collect millions in commissions from insurers.
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Court evidence showed the operation sought more than $233 million in fraudulent subsidies, with the federal government ultimately paying out at least $180 million. Investigators said false applications were routinely submitted using fabricated or misleading income information, and additional steps were taken to bypass federal eligibility checks.
Some victims were unknowingly shifted away from legitimate coverage such as Medicaid, placing access to treatment for serious medical and behavioral conditions at risk.
Authorities described the conduct as calculated and deeply harmful, emphasizing that the fraud not only diverted public funds but also endangered medically fragile individuals. Evidence presented at trial included communications in which the defendants discussed profits and disparaged the people they enrolled.
“These defendants designed a purposeful scheme to profit from human suffering, targeting individuals at their most vulnerable moments, solely for personal gain,” said Inspector General T. March Bell of the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG).
The two men were each sentenced to 20 years in federal prison and ordered to pay more than $180 million in restitution. One defendant was also convicted of money laundering charges. A third participant previously pleaded guilty and received a separate prison sentence.
Federal investigators from multiple agencies led the case, which prosecutors said underscores an ongoing effort to pursue complex health care fraud and protect programs designed to serve vulnerable communities.
