DataBreaches.Net

Menu
  • About
  • Breach Notification Laws
  • Privacy Policy
  • Transparency Report
Menu

Miami-Dade County, Florida, Man Charged With Conspiracy To Commit Health Care Fraud

Posted on November 16, 2016 by Dissent

Here’s a case of insurance info theft to fuel a fraud scheme:

NEWARK, N.J. – A Florida man has been charged in connection with his role in establishing fake medical facilities in New Jersey and billing insurance companies for services that were never performed, U.S. Attorney Paul J. Fishman announced.

Eduardo Arango Chong, 21, of Hialeah, Florida, was arrested Nov. 15, 2016, and will appear today before U.S. Magistrate Judge Cathy L. Waldor in Newark federal court. He was charged by complaint, along with Osmaro Ruiz, 31, of Homestead, Florida, with one count of conspiracy to commit health care fraud. Ruiz remains at large. Another conspirator, Raymel Betancourt, 25, was charged with healthcare fraud in a separate complaint in June 2015.

According to the complaint:

From September 2014 through June 26, 2015, the defendants allegedly established fictitious health service providers in Union County, New Jersey, and elsewhere. These “phantom providers” repeatedly submitted false claims to insurance companies for medical services, including injections and physical therapy services, that were never actually performed. They allegedly submitted claims for more than $6 million and the insurance companies paid hundreds of thousands of dollars to the phantom providers.

The defendants allegedly recruited people with legitimate health insurance policies from real companies, offering them money in exchange for allowing the phantom providers to use this information.

The fake providers also used health insurance information for individuals who were not aware that fraudulent claims were being submitted on their behalf. The conspirators logged on to an electronic healthcare network used by medical practices to check patient insurance coverage. They used valid member IDs and then entered a series of consecutive potential member IDs until one of the numbers was linked to someone with a valid health insurance plan and accepted by the network. 

Checks and proceeds issued by the insurance companies were cashed or deposited into bank accounts established by the conspirators.

The counts of conspiracy to commit health care fraud with which the defendants are charged carry a maximum potential penalty of 10 years in prison and a $250,000 fine, or twice the gross gain or loss from the offense.

U.S. Attorney Fishman credited special agents of the U.S. Postal Inspection Service, under the direction of Inspector in Charge Maria L. Kelokates, and special agents of the FBI, under the direction of Special Agent in Charge Timothy Gallagher, with the investigation leading to the charges.

The government is represented by Assistant U.S. Attorney Karen D. Stringer of the Criminal Division.

U.S. Attorney Fishman reorganized the health care fraud practice at the New Jersey U.S. Attorney’s Office shortly after taking office, including creating a stand-alone Health Care and Government Fraud Unit to handle both criminal and civil investigations and prosecutions of health care fraud offenses. Since 2010, the office has recovered more than $1.29 billion in health care fraud and government fraud settlements, judgments, fines, restitution and forfeiture under the False Claims Act, the Food, Drug, and Cosmetic Act and other statutes.

The charges and allegations in the complaint are merely accusations, and the defendants are considered innocent unless and until proven guilty.

SOURCE: U.S. Attorney’s Office, District of New Jersey

Category: Health DataID TheftOtherU.S.

Post navigation

← TX: Fourth Defendant Convicted in Scheme that Defrauded Electronic Arts of More Than $16 Million Worth of Virtual Currency
AU: Personal details of thousands of residents revealed by Melbourne council in data breach →

Now more than ever

"Stand with Ukraine:" above raised hands. The illustration is in blue and yellow, the colors of Ukraine's flag.

Search

Browse by Categories

Recent Posts

  • New evidence links long-running hacking group to Indian government
  • Zaporizhzhia Cyber ​​Police Exposes Hacker Who Caused Millions in Losses to Victims by Mining Cryptocurrency
  • Germany fines Vodafone $51 million for privacy, security breaches
  • Google: Hackers target Salesforce accounts in data extortion attacks
  • The US Grid Attack Looming on the Horizon
  • US govt login portal could be one cyberattack away from collapse, say auditors
  • Two Men Sentenced to Prison for Aggravated Identity Theft and Computer Hacking Crimes
  • 100,000 UK taxpayer accounts hit in £47m phishing attack on HMRC
  • CISA Alert: Updated Guidance on Play Ransomware
  • Almost one year later, U.S. Dermatology Partners is still not being very transparent about their 2024 breach

No, You Can’t Buy a Post or an Interview

This site does not accept sponsored posts or link-back arrangements. Inquiries about either are ignored.

And despite what some trolls may try to claim: DataBreaches has never accepted even one dime to interview or report on anyone. Nor will DataBreaches ever pay anyone for data or to interview them.

Want to Get Our RSS Feed?

Grab it here:

https://databreaches.net/feed/

RSS Recent Posts on PogoWasRight.org

  • How the FBI Sought a Warrant to Search Instagram of Columbia Student Protesters
  • Germany fines Vodafone $51 million for privacy, security breaches
  • Malaysia enacts data sharing rules for public sector
  • U.S. Enacts Take It Down Act
  • 23andMe Bankruptcy Judge Ponders Trump Bill’s Injunction Impact
  • Hell No: The ODNI Wants to Make it Easier for the Government to Buy Your Data Without Warrant
  • US State Dept. says silence or anonymity on social media is suspicious

Have a News Tip?

Email: Tips[at]DataBreaches.net

Signal: +1 516-776-7756

Contact Me

Email: info[at]databreaches.net

Mastodon: Infosec.Exchange/@PogoWasRight

Signal: +1 516-776-7756

DMCA Concern: dmca[at]databreaches.net
© 2009 – 2025 DataBreaches.net and DataBreaches LLC. All rights reserved.